Individual
MICHELLE ALYS ST. RAYMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1934 MADISON ST, MANDEVILLE, LA 70448-5841
(985) 674-4113
(985) 674-4113
Mailing address
1934 MADISON ST, MANDEVILLE, LA 70448-5841
(985) 674-4113
(985) 674-4113
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3353
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
586309
VALUE OPTIONS PROVIDER
LA
Enumeration date
02/20/2007
Last updated
12/15/2008
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