SHANIQUE TIARRA WILLIS

FERRIDAY, LA
NPI1740054212
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: LA  CP025842A)
Additional Taxonomies225200000X Physical Therapy Assistant
(Licence: SC  4356)
225200000X Physical Therapy Assistant
(Licence: GA  PTA005056)
Enumeration Date2023-11-14
Last Update Date2023-11-14
Business Address
SHANIQUE TIARRA WILLIS
110 SERIO BLVD
FERRIDAY, LA 71334-2013
Phone number: 318-757-8671
Mailing Address
SHANIQUE TIARRA WILLIS
10 PINENEEDLE CT
SUMTER, SC 29150-8863
Phone number:
Similar providers in Ferriday, LA
DETRICK LASHAE WINDING
ALEXA LAZARUS