Individual
DR. STACIE NWABUEZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3050 CHARLES DR, JACKSON, LA 70748-6135
(225) 634-3517
(225) 634-5057
Mailing address
3050 CHARLES DR, JACKSON, LA 70748-6135
(225) 634-3517
(225) 634-5057
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
LRC-790
LA
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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