Individual
MARISSA HOPE PERALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
751 BAYOU PINES EAST DR STE C, LAKE CHARLES, LA 70601-7196
(337) 433-3292
Mailing address
2525 YOUREE DR, SHREVEPORT, LA 71104-3671
(318) 675-0804
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
62663
TX
Other
Enumeration date
08/08/2016
Last updated
08/08/2016
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