Individual
KANASHA GANTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1945 E 70TH ST STE E, SHREVEPORT, LA 71105-5347
(318) 658-9927
Mailing address
1945 E 70TH ST STE E, SHREVEPORT, LA 71105-5347
(318) 658-9927
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Enumeration date
09/04/2019
Last updated
11/27/2023
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