Individual
GWENDOLYN CASEY-HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2520 CRESTWOOD DR, SHREVEPORT, LA 71118-2113
(318) 868-3093
(318) 868-3094
Mailing address
2520 CRESTWOOD DR, SHREVEPORT, LA 71118-2113
(318) 868-3093
(318) 868-3094
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2304852
—
LA
Enumeration date
05/19/2022
Last updated
05/19/2022
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