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Individual

KATHRYN MOUTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW-BACS

Contact information

Practice address
825 ARDMORE ST, LAKE CHARLES, LA 70605-5417
(337) 802-8871
Mailing address
825 ARDMORE ST, LAKE CHARLES, LA 70605-5417
(337) 802-8871

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2916
LA

Other

Enumeration date
06/15/2016
Last updated
06/15/2016
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