Individual
DE'SHANAE RENAE DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 N ALEXANDER AVE, PORT ALLEN, LA 70767-2514
(225) 382-0665
Mailing address
220 N ALEXANDER AVE, PORT ALLEN, LA 70767-2514
(225) 382-0665
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.021847
LA
Other
Enumeration date
12/05/2016
Last updated
12/05/2016
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