Individual
SHANTA R WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6850 MANHATTAN BLVD # 704, FORT WORTH, TX 76120-1227
(682) 615-0410
Mailing address
6850 MANHATTAN BLVD # 704, FORT WORTH, TX 76120-1227
(682) 615-0410
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
43125839
TX
Other
Enumeration date
10/10/2020
Last updated
10/10/2020
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