Individual
KANISHA PEARL TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1103 COLLEGE ST, SHREVEPORT, LA 71104-2034
(318) 572-3871
Mailing address
1103 COLLEGE ST, SHREVEPORT, LA 71104-2034
(318) 572-3871
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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