Individual
KELLEY TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
315 ALAMO ST, LAKE CHARLES, LA 70601-8528
(337) 226-7504
Mailing address
354 PINE RIDGE RD, DERIDDER, LA 70634-5350
(337) 226-7504
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5135
LA
Other
Enumeration date
05/19/2023
Last updated
07/13/2023
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