Individual
DONESHA ALISSA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
643 ALEXANDER ST, GRAND PRAIRIE, TX 75051-6007
(214) 802-9155
Mailing address
643 ALEXANDER ST, GRAND PRAIRIE, TX 75051-6007
(214) 802-9155
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
319419
TX
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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