Provider Demographics
NPI:1982216842
Name:SMITH, CARLA
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:SMITH
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 1:1760 TEXAS ST
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-3429
Mailing Address - Country:US
Mailing Address - Phone:318-238-8801
Mailing Address - Fax:318-228-8803
Practice Address - Street 1:1760 TEXAS ST
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-3429
Practice Address - Country:US
Practice Address - Phone:318-238-8801
Practice Address - Fax:318-228-8803
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator