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Individual

MRS. JUANITA WALLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3600 GOVERNMENT ST, ALEXANDRIA, LA 71302-3324
(318) 792-3338
Mailing address
5909 DEERFIELD DR, ALEXANDRIA, LA 71301-2414
(318) 792-3338

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
LA

Other

Enumeration date
09/13/2016
Last updated
09/13/2016
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