Individual
JA'LISA TADEMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5417 JACKSON ST, SUITE D, ALEXANDRIA, LA 71303-2322
(318) 473-4328
Mailing address
2525 YOUREE DR, SHREVEPORT, LA 71104-3671
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/25/2016
Last updated
02/25/2016
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