Individual
STACI WHITESIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A, LPC
Contact information
Practice address
441 HOLMES DR, SLIDELL, LA 70460-8431
(985) 774-7500
Mailing address
441 HOLMES DR, SLIDELL, LA 70460-8431
(985) 774-7500
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4670
LA
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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