Individual
DETRA GAULDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3452 HALSEY STREET, ALEXANDRIA, LA 71301
(318) 613-1571
Mailing address
3452 HALSEY STREET, ALEXANDRIA, LA 71301
(318) 613-1571
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/26/2016
Last updated
04/26/2016
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