Individual
MS. LACEY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1160 CAMP ST, NEW ORLEANS, LA 70130-4202
(504) 522-4476
(504) 522-0342
Mailing address
1160 CAMP ST, NEW ORLEANS, LA 70130-4202
(504) 522-4476
(504) 522-0342
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1159
LA
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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