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1043871759
TANISHA BULLARD
SHREVEPORT, LA
NPI
1043871759
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: MS NA)
Enumeration Date
2019-06-24
Last Update Date
2019-06-24
Business Address
TANISHA BULLARD
3341 YOUREE DR
SHREVEPORT, LA 71105-2149
Phone number: 318-219-4364
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Mailing Address
TANISHA BULLARD
3341 YOUREE DR
SHREVEPORT, LA 71105-2149
Phone number: 318-219-4364
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