Individual
ANGELA WALTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4728 JEFFERSON HWY, JEFFERSON, LA 70121-3125
(504) 734-0501
Mailing address
4728 JEFFERSON HWY, JEFFERSON, LA 70121-3125
(504) 734-0501
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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