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Individual

CARLIS JEAN LAWRENCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
108 E SANDERS ST, GONZALES, LA 70737
(225) 647-4105
Mailing address
321 BRANDYWINE BLVD, THIBODAUX, LA 70301-6156
(225) 717-2189

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
171M00000X
Case Manager/Care Coordinator
Primary
171M00000X

Other

Enumeration date
06/29/2018
Last updated
07/23/2018
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