Individual
TASHEKA RENA STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10652 HIGHWAY1045, AMITE, LA 70422
(985) 348-8287
Mailing address
11466 JAMES RD, AMITE, LA 70422-5620
(985) 348-8287
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
07/21/2021
Last updated
07/21/2021
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