Individual
BRENDA ANN DISIMONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
8912 VETERANS MEMORIAL BLVD, METAIRIE, LA 70003-5200
(504) 465-0171
(504) 465-9047
Mailing address
2213 TAFFY DR, KENNER, LA 70065-3861
(504) 232-0177
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
007653
LA
Other
Enumeration date
05/04/2021
Last updated
05/04/2021
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