Individual
LAKETA SHAVONNE WOODS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1109 FAIRVIEW ST, TEXARKANA, AR 71854-7515
(903) 651-1479
Mailing address
1109 FAIRVIEW ST, TEXARKANA, AR 71854-7515
(903) 651-1479
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
300587
TX
Other
Enumeration date
02/21/2018
Last updated
02/21/2018
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