Individual
ALISA WILLOUGHBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8719 BATTLE RD, ETHEL, LA 70730-4007
(225) 205-9473
Mailing address
8719 BATTLE RD, ETHEL, LA 70730-4007
(225) 205-9473
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
230786
LA
Other
Enumeration date
07/07/2023
Last updated
10/08/2024
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