Individual
STELLA WILTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OWNER
Contact information
Practice address
402 RICHARD STREET, BREAUX BRIDGE, LA 70517-7051
(337) 278-1810
Mailing address
400 RICHARD ST, BREAUX BRIDGE, LA 70517-6039
(337) 332-1810
(337) 332-3300
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
3747P1801X
Personal Care Attendant
Primary
11226
LA
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1721999
—
LA
05
—
84-368-5768
—
LA
Enumeration date
05/14/2007
Last updated
05/20/2022
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