Individual
PATRICIA SHELTON-RAMBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2210 LINE AVE STE 207, SHREVEPORT, LA 71104-2134
(318) 675-1112
Mailing address
PO BOX 1415, MINDEN, LA 71058-1415
(318) 518-4521
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
18174
LA
171M00000X
Case Manager/Care Coordinator
—
—
225200000X
Physical Therapy Assistant
A5169
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417384025
—
LA
Enumeration date
12/05/2018
Last updated
12/21/2023
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