Individual
LISA WADSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
289 KELLY LN, FRIERSON, LA 71027-1905
(318) 470-5924
Mailing address
289 KELLY LN, FRIERSON, LA 71027-1905
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/12/2017
Last updated
04/12/2017
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