Individual
BRANDY WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3929 BAXTER ST, SHREVEPORT, LA 71109-7431
(318) 207-4012
Mailing address
3929 BAXTER ST, SHREVEPORT, LA 71109-7431
(318) 207-4012
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/17/2021
Last updated
03/17/2021
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