Individual
MALLORI ELIZABETH DIEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9915 E GRONER AVE, BATON ROUGE, LA 70809-3817
(225) 939-1857
Mailing address
9915 E GRONER AVE, BATON ROUGE, LA 70809-3817
(225) 939-1857
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11847
LA
Other
Enumeration date
01/26/2021
Last updated
01/26/2021
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