Individual
MRS. TERRY COLLINS AINSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
787 N 7TH ST STE A, PONCHATOULA, LA 70454-3115
(985) 974-0429
(504) 294-8310
Mailing address
42484 BLYTH AVE, PONCHATOULA, LA 70454-5498
(985) 974-0429
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6541
LA
Other
Enumeration date
05/28/2020
Last updated
10/10/2022
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