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Individual

IDA ANSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
137 N CLARK ST, NEW ORLEANS, LA 70119-5244
(219) 616-5476
Mailing address
137 N CLARK ST, NEW ORLEANS, LA 70119-5244
(219) 616-5476

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
05/29/2019
Last updated
08/23/2021
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