Shanique Tiarra Willis

NPI #1740054212 in Ferriday, Louisiana

Provider Information

NPI Number: 1740054212
Entity Type: Individual
Name: Shanique Tiarra Willis
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Nov 14, 2023
Last Updated: Nov 14, 2023

Practice Location

Address: 110 SERIO BLVD
City: Ferriday
State: Louisiana
ZIP Code: 71334-2013
Phone: (318) 757-8671

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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