Individual
LAQUITA CLEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
207 N PANAMA ST, MADISONVILLE, TX 77864-1546
(936) 349-0589
(866) 562-2811
Mailing address
207 N PANAMA ST, MADISONVILLE, TX 77864-1546
(936) 349-0589
(866) 562-2811
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
9611
TX
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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