Individual
MCKENZIE NICHOLE GAUTHIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2495 SHREVEPORT HWY, ALEXANDRIA, LA 71306-9004
(318) 466-2260
Mailing address
1612 PLANTATION DR, ALEXANDRIA, LA 71301-3224
(318) 481-1043
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8318
LA
Other
Enumeration date
12/22/2008
Last updated
02/18/2010
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