Tanisha Bullard

NPI #1043871759 in Shreveport, Louisiana

Provider Information

NPI Number: 1043871759
Entity Type: Individual
Name: Tanisha Bullard
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Enumeration Date: Jun 24, 2019
Last Updated: Jun 24, 2019

Practice Location

Address: 3341 YOUREE DR
City: Shreveport
State: Louisiana
ZIP Code: 71105-2149
Phone: (318) 219-4364

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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