Individual
ELIZABETH WALTERS VIVIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LPC, PMH-C
Contact information
Practice address
8631 SUMMA AVE, BATON ROUGE, LA 70809-3678
(225) 933-2373
(225) 410-2990
Mailing address
8631 SUMMA AVE, BATON ROUGE, LA 70809-3678
(225) 933-2373
(225) 410-2990
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4635
LA
Other
Enumeration date
06/17/2012
Last updated
01/21/2022
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