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Organization

MARY DEAN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARY M DEAN LCSW (THERAPIST)
(469) 585-6732
Entity
Organization

Contact information

Practice address
333 S MAIN ST, OPELOUSAS, LA 70570-6137
(337) 945-1032
(337) 205-8531
Mailing address
333 S MAIN ST, OPELOUSAS, LA 70570-6137
(337) 945-1032
(337) 205-8531

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12743
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
600991533
LA
Enumeration date
01/25/2017
Last updated
01/25/2017
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