Individual
SAMANTHA MODISETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2114 BAUCUM PL, HAYNESVILLE, LA 71038-5613
(318) 433-1419
Mailing address
2114 BAUCUM PL, HAYNESVILLE, LA 71038-5613
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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