Individual
SHANIHIA WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
402 LEGACY PARK, RIDGELAND, MS 39157-4315
(769) 233-7154
Mailing address
225 W MCDOWELL RD APT K5, JACKSON, MS 39204-5640
(601) 868-3628
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/23/2026
Last updated
04/23/2026
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