Provider Demographics
NPI:1710616545
Name:SUDDS, DARLENE M
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:M
Last Name:SUDDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7591 FERN AVE STE 1703
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5749
Mailing Address - Country:US
Mailing Address - Phone:318-221-2828
Mailing Address - Fax:318-221-2998
Practice Address - Street 1:7591 FERN AVE STE 1703
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5749
Practice Address - Country:US
Practice Address - Phone:318-221-2828
Practice Address - Fax:318-221-2998
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator