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Individual

LASHATTE DEAQUANITA ALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9245 WALLACE LAKE RD, SHREVEPORT, LA 71106-7331
(318) 221-2828
Mailing address
PO BOX 349, STONEWALL, LA 71078-0349

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary

Other

Enumeration date
10/21/2017
Last updated
10/21/2017
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