Individual
MS. TASHA LANETTE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7617 PINES RD, SHREVEPORT, LA 71129-3905
(318) 564-7672
Mailing address
6331 WESTPORT AVE, SHREVEPORT, LA 71129-2415
(318) 564-7672
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
—
LA
224P00000X
Prosthetist
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
224P00000X
PROSTHETIST
LA
Enumeration date
12/05/2019
Last updated
07/11/2024
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