Individual
SONJA TULLOS SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC 978
Contact information
Practice address
804 N 2ND ST, AMITE, LA 70422-2117
(985) 517-1711
(985) 747-8836
Mailing address
804 N 2ND ST, AMITE, LA 70422-2117
(985) 517-1711
(985) 747-8836
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
978
LA
Other
Enumeration date
08/06/2015
Last updated
08/06/2015
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