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General NPI Number Information
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NPI Number | 1679586291
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Entity Type | Individual
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Provider Name | VICKI RACHAL LABORDE LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 510 E. STONER AVENUE OBVAMC (116)
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City | SHREVEPORT
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State | LA
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Zip | 71101
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Country | US
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Telephone | 318-221-8411
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Fax | 318-841-4774
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Provider Business Mailing Address
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Address Line | 510 E. STONER AVENUE (110) OBVAMC
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City | SHREVEPORT
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State | LA
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Zip | 71101-8530
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Country | US
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Telephone | 318-184-7822
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5841
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License Number State | LA
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