Individual
DARIKA LANAY KIRKENDOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9403 MANSFIELD RD, SHREVEPORT, LA 71118
(318) 861-8938
Mailing address
9403 MANSFIELD RD, SHREVEPORT, LA 71118-3815
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176852511
—
LA
Enumeration date
09/06/2017
Last updated
05/17/2018
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