Individual
TANISHA SHARDA WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1116 ADNER RD, HAUGHTON, LA 71037-8015
(318) 507-9236
Mailing address
1116 ADNER RD, HAUGHTON, LA 71037-8015
(318) 507-9236
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/29/2016
Last updated
09/29/2016
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