Provider Demographics
NPI:1841501467
Name:WARE, VERA MITCHELL (RRT)
Entity type:Individual
Prefix:MRS
First Name:VERA
Middle Name:MITCHELL
Last Name:WARE
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
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Mailing Address - Street 1:9591 WALLACE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-7535
Mailing Address - Country:US
Mailing Address - Phone:318-687-8813
Mailing Address - Fax:318-687-8813
Practice Address - Street 1:9591 WALLACE LAKE RD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-7535
Practice Address - Country:US
Practice Address - Phone:318-687-8813
Practice Address - Fax:318-687-8813
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LALT35252279H0200X, 2279P1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health
No2279P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Rehabilitation