Individual
MACY AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 TIGER DR, SIMSBORO, LA 71275-3039
(318) 247-6265
Mailing address
1646 HIGHWAY 546, WEST MONROE, LA 71292-2182
(318) 680-1581
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8236
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/01/2019
Last updated
05/22/2024
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