Individual
TAMIKKA ROSE SHORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1191 ROSEWAY BLVD, ZACHARY, LA 70791-7335
(225) 620-9934
Mailing address
1191 ROSEWAY BLVD, ZACHARY, LA 70791-7335
(225) 620-9934
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
251B00000X
Case Management Agency
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
10/27/2021
Last updated
10/28/2021
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