Individual
MRS. GWEN NORMAND MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 473-0010
(318) 483-5190
Mailing address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 473-0010
(318) 483-5190
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4298
LA
Other
Enumeration date
08/21/2013
Last updated
02/06/2017
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