Individual
TIA ALEXANDRA HENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
700 GAUSE BLVD STE 201, SLIDELL, LA 70458-2853
(985) 326-8501
Mailing address
700 GAUSE BLVD STE 201, SLIDELL, LA 70458-2853
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
241134
LA
Other
Enumeration date
01/10/2018
Last updated
01/10/2018
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