Individual
LAQUARDRICK CANADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
107 CAROLYN ST, MANSFIELD, LA 71052-2901
(318) 461-1260
Mailing address
107 CAROLYN ST, MANSFIELD, LA 71052-2901
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/17/2016
Last updated
06/17/2016
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