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Individual

KASSIE TANNEHILL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LOTR

Contact information

Practice address
1730 S FOURTH ST, JENA, LA 71342-4084
(318) 316-3020
Mailing address
109 DESPERADO RD, TROUT, LA 71371-4501

Taxonomy

Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
225X00000X
Occupational Therapist
Primary
340116
LA

Other

Enumeration date
01/12/2024
Last updated
03/06/2026
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