Individual
DESTINEE NICOLE HEBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 SOUTHFIELD RD, SHREVEPORT, LA 71105-3702
(318) 861-2431
Mailing address
1970 WILD IRIS, BOSSIER CITY, LA 71112-4681
(337) 654-0859
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
021265
LA
Other
Enumeration date
02/27/2018
Last updated
02/27/2018
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