Individual
MS. VILLARY VENITA PAILLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9159 SOUTHWOOD DR, SHREVEPORT, LA 71118-3039
(318) 655-6835
Mailing address
9159 SOUTHWOOD DR, SHREVEPORT, LA 71118-3039
(318) 655-6835
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
007232111
LA
Other
Enumeration date
05/09/2019
Last updated
05/09/2019
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