Individual
ALICIAH KAE SOUZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
644 E JEFFERSON AVE, BASTROP, LA 71220-4619
(318) 239-3862
(318) 239-3867
Mailing address
810 E PECAN AVE, BASTROP, LA 71220-5124
(310) 974-3055
(318) 239-3867
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
471411453
LA
Other
Enumeration date
11/04/2016
Last updated
11/04/2016
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