Individual
SHANIQUA LA'SHAE MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
211 COUNTY ROAD 2781, CARTHAGE, TX 75633-6194
(903) 754-0059
Mailing address
211 COUNTY ROAD 2781, CARTHAGE, TX 75633-6194
(903) 754-0059
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
43026
TX
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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