Provider Demographics
NPI:1457708653
Name:TODD, SHEILA (BA)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:TODD
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 SHADYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-3816
Mailing Address - Country:US
Mailing Address - Phone:318-946-8157
Mailing Address - Fax:318-216-5868
Practice Address - Street 1:2010 SHADYWOOD LN
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-3816
Practice Address - Country:US
Practice Address - Phone:318-946-8157
Practice Address - Fax:318-216-5868
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator