Individual
DALE ELLEN STANDIFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
20050 MEDUS ST, COVINGTON, LA 70435-0162
(504) 228-9265
Mailing address
20050 MEDUS ST, COVINGTON, LA 70435-0162
(504) 228-9265
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3434
LA
Other
Enumeration date
01/20/2013
Last updated
01/20/2013
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