Individual
STACEY LEANNE DILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
130 JEFFERSON ST, MANSFIELD, LA 71052-2602
(318) 872-2700
Mailing address
130 JEFFERSON ST, MANSFIELD, LA 71052-2602
(318) 872-2700
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10036
LA
Other
Enumeration date
02/15/2012
Last updated
05/04/2020
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