Individual
TANEIL JADE VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 S I-10 SERVICE RD W MATAIRIE, SUITE 117, NEW ORLEANS, LA 70002
(504) 841-0007
Mailing address
5700 SAINT ANTHONY AVE APT 115, NEW ORLEANS, LA 70122-4103
(504) 229-1491
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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