Individual
LYDIE MARY PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, RN
Contact information
Practice address
229 JULES AVE, JEFFERSON, LA 70121-2820
(504) 628-8730
Mailing address
229 JULES AVE, JEFFERSON, LA 70121-2820
(504) 628-8730
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7372
LA
Other
Enumeration date
03/04/2016
Last updated
03/04/2016
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