Individual
MRS. DAPHNE LANE NIERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1723 BAYOU DR, SHREVEPORT, LA 71105-3401
(318) 751-3484
Mailing address
1723 BAYOU DR, SHREVEPORT, LA 71105-3401
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.Z20578
LA
Other
Enumeration date
01/22/2012
Last updated
01/22/2012
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