Individual
KELLI HILLIARD MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4105 KIRKMAN ST, LAKE CHARLES, LA 70607-4603
(337) 475-8022
(337) 475-8054
Mailing address
4105 KIRKMAN ST, LAKE CHARLES, LA 70607-4603
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9060
LA
Other
Enumeration date
03/10/2011
Last updated
03/10/2011
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