Individual
PAIGE F VANDERLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
109 YORKTOWN DR, SUITE B, ALEXANDRIA, LA 71303-3621
(318) 487-9895
(318) 767-3339
Mailing address
109 YORKTOWN DR, SUITE B, ALEXANDRIA, LA 71303-3621
(318) 487-9895
(318) 767-3339
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3617
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1655635
—
LA
Enumeration date
06/20/2006
Last updated
11/17/2008
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