Individual
TA'NIA HIGGINBOTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12125 HIGHWAY 90, LULING, LA 70070-3000
(985) 785-9054
Mailing address
529 GREENWOOD DR, LA PLACE, LA 70068-2723
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.025045
LA
Other
Enumeration date
10/11/2023
Last updated
10/11/2023
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