Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156F00000X | Technician/Technologist | 11278 | MT |
Y | 156F00000X | Technician/Technologist | 306723 | LA |
N | 156F00000X | Technician/Technologist | 51873 | FL |
NPI | 1003449679 |
---|---|
Provider Name | Ms. Terran Sweeney |
First Address | Sulphur, LA 70663-3335 |
Second Address | Sulphur, LA 70663-3335 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2020 |
Last Update Date | 21/02/2020 |