Individual
MARILYN EZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
904 DEVILLE LN, RUSTON, LA 71270-6313
(318) 255-5575
(318) 255-5457
Mailing address
904 DEVILLE LN, RUSTON, LA 71270-6313
(318) 255-5575
(318) 255-5457
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3502
LA
Other
Enumeration date
07/13/2015
Last updated
07/13/2015
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