Individual
MALLORY BUUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
309 SAINT JULIEN AVE STE 201, LAFAYETTE, LA 70506-4655
(337) 706-3415
Mailing address
309 SAINT JULIEN AVE STE 201, LAFAYETTE, LA 70506-4655
(337) 706-1940
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
16535
LA
Other
Enumeration date
02/05/2024
Last updated
04/15/2024
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