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Individual
MRS. ALICIA LACHELLE WALLACE STEVENS
Active
Individual
MRS. ALICIA LACHELLE WALLACE STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21723
MS
207R00000X
Internal Medicine Physician
PGY.2.TUL-MEDPD
LA
208000000X
Pediatrics Physician
21723
MS
208000000X
Pediatrics Physician
PGY.2.TUL-MEDPD
LA
Other
Enumeration date
12/24/2007
Last updated
07/20/2020
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