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Individual

CLAIRE SHIDLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2920 KNIGHT ST, SHREVEPORT, LA 71105-2412
(318) 213-1804
Mailing address
1239 WHITEHALL DR, BOSSIER CITY, LA 71112-4585
(318) 426-0179

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
171MOOOOOX
LA
Enumeration date
08/15/2023
Last updated
11/05/2025
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