DOMINIQUE SHANICIA GRISBY

SHREVEPORT, LA
NPI1417781030
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2024-08-27
Last Update Date2024-08-27
Business Address
DOMINIQUE SHANICIA GRISBY PMHNP
OVERTON BROOKS VA MEDICAL CENTER 510 E STONER AVE
SHREVEPORT, LA 71101
Phone number: 318-221-8411
Mailing Address
DOMINIQUE SHANICIA GRISBY PMHNP
1603 HASSELL CIR
BOSSIER CITY, LA 71112-4682
Phone number: 318-918-5902