Individual
MICHAEL GENE WALDRIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1799 STUMPF BLVD., BUILDING 3, SUITE 2, TERRYTOWN, LA 70056-7005
(504) 255-4205
Mailing address
3715 LAKE VILLA DR, METAIRIE, LA 70002-4331
(504) 255-4205
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5590
LA
Other
Enumeration date
08/13/2019
Last updated
08/13/2019
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