Individual
DIJON PHOENIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
710 VERSAILLES BLVD, ALEXANDRIA, LA 71303-2351
(318) 787-6749
Mailing address
2337 VANCE AVE, ALEXANDRIA, LA 71301-4664
(318) 787-1133
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
LA
Other
Enumeration date
01/06/2017
Last updated
01/06/2017
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