Individual
DANIYA IMTHIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(661) 375-8855
Mailing address
262 CULLOM DR, BOSSIER CITY, LA 71112-2085
(661) 375-8855
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
LA
Other
Enumeration date
05/06/2026
Last updated
05/06/2026
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