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NPI Code Detail

MEDICARE: TANGELA MARIE BETFORD PLMSW

MEDICARE: TANGELA MARIE BETFORD PLMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker10016LA

General Provider Information

NPI Number : 1124467139
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANGELA MARIE BETFORD PLMSW
Provider Business Mailing Address
First Line : 4571 N MARKET ST
Second Line :
City : SHREVEPORT
State : LA
Zip : 71107-2917
Country : US
Telephone Number : 318-424-8735
Fax Number :
Provider Business Practice Location Address
First Line : 4571 N MARKET ST
Second Line :
City : SHREVEPORT
State : LA
Zip : 71107-2917
Country : US
Telephone Number : 318-424-8735
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2013
Last Update Date : 12/15/2025

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Directions to “ TANGELA MARIE BETFORD PLMSW” Practice Location

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