Individual
TAQUASHA NETTLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3708 GANNET DR, MESQUITE, TX 75181-2982
(972) 940-3553
Mailing address
3708 GANNET DR, MESQUITE, TX 75181-2982
(972) 940-3553
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5220
—
MI
Enumeration date
07/05/2022
Last updated
04/05/2023
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