Individual
BILLIE SUE WALLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1001 W PINHOOK RD STE 305 BLDG 3, LAFAYETTE, LA 70503-2487
(337) 237-9150
Mailing address
PO BOX 1254, BROUSSARD, LA 70518-1254
(337) 234-5656
(337) 234-5670
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9283
LA
Other
Enumeration date
02/01/2007
Last updated
07/08/2007
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