Individual
CANDICE MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
6205 N WINDERMERE DR, SHREVEPORT, LA 71129-3422
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
109328
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109328
SOCIAL WORK
TX
Enumeration date
03/02/2023
Last updated
03/02/2023
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