Individual
TANGANYIKA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9312 CANA DR, SHREVEPORT, LA 71118-2808
(318) 470-0308
Mailing address
9312 CANA DR, SHREVEPORT, LA 71118-2808
(318) 470-0308
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/19/2022
Last updated
04/19/2022
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