Individual
CARLLISHIA M MOSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
351 SOUTHFIELD RD, SHREVEPORT, LA 71105-4140
(318) 230-5168
Mailing address
351 SOUTHFIELD RD, SHREVEPORT, LA 71105-4140
(318) 230-5168
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
884058080
NON MEDICAE
LA
Enumeration date
01/09/2023
Last updated
01/09/2023
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