Individual
MRS. STACEY F. KIDDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W, L.C.S.W.
Contact information
Practice address
9035 BLUEBONNET BLVD., BLDG. 1, BATON ROUGE, LA 70810
(225) 769-5990
Mailing address
9035 BLUEBONNET BLVD, BLDG. 1, BATON ROUGE, LA 70810-2841
(225) 769-5990
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6765
LA
Other
Enumeration date
03/15/2007
Last updated
06/10/2013
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