Individual
LATEISHA T DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3045 HOYTE DR, SHREVEPORT, LA 71118-2407
(318) 344-4999
Mailing address
3045 HOYTE DR, SHREVEPORT, LA 71118-2407
(318) 344-4999
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
04/20/2022
Last updated
04/20/2022
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