Shanique Tiarra Willis
Shanique Tiarra Willis is a Physical Therapy Assistant in Ferriday, Louisiana. Practices as a sole proprietor. Licensed in Georgia, Louisiana and South Carolina.
- Licensed in
- GA, LA, SC
- In the registry since
- 2023
- Specialties on file
- 3
Practice location Address checks out
110 Serio BlvdFerriday, LA 71334-2013
Phone: (318) 757-8671
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physical Therapy Assistant (primary) | Taxonomy 225200000X · Licence CP025842A (LA) |
|---|---|
| Physical Therapy Assistant | Taxonomy 225200000X · Licence 4356 (SC) |
| Physical Therapy Assistant | Taxonomy 225200000X · Licence PTA005056 (GA) |
Record details
| NPI number | 1740054212 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | November 14, 2023 |
| Last updated in NPPES | November 14, 2023 |
| Certification date | November 14, 2023 |
Other providers in Ferriday
-
Alexa Lazarus
110 Serio Blvd, Ferriday, LA 71334-2013 · (318) 757-4050
-
Detrick Lashae Winding, PTA
110 Serio Blvd, Ferriday, LA 71334 · (318) 757-4030