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Individual

MRS. DILDRED SMALL WOMACK

Active
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Individual

MRS. DILDRED SMALL WOMACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT, LPC-S

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
TYPE A. 041732 & 266
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
266
LA
101YM0800X
Mental Health Counselor
266
LA
101YP2500X
Professional Counselor
266
LA
101YS0200X
School Counselor
TYPE A. 041732
LA
106H00000X
Marriage & Family Therapist
94
LA
171000000X
Military Health Care Provider

Other

Enumeration date
01/16/2007
Last updated
02/08/2011
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