Individual
KENISHA SLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21 LAZY SWING CT, MANVEL, TX 77578-1570
(808) 728-9240
Mailing address
21 LAZY SWING CT, MANVEL, TX 77578-1570
(808) 728-9240
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
338575
TX
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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