Individual
KILEY P CEDOTAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW-BACS, FACHE
Contact information
Practice address
532 PONDEROSA DR, PONCHATOULA, LA 70454-9428
(225) 715-8768
Mailing address
532 PONDEROSA DR, PONCHATOULA, LA 70454-9428
(225) 715-8768
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6181
LA
Other
Enumeration date
01/22/2025
Last updated
01/22/2025
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