Individual
MRS. IVY DESIRAE BENNETT SIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., NCC, LPC
Contact information
Practice address
1010 AUBURN AVE, LAFAYETTE, LA 70503-2308
(337) 232-9457
(337) 232-9459
Mailing address
326 SAINT MATTHIAS DR, CARENCRO, LA 70520-5576
(310) 429-5025
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
5550
LA
101YP2500X
Professional Counselor
Primary
5550
LA
Other
Enumeration date
09/29/2015
Last updated
09/29/2015
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