Individual
CAROLYN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 S 3RD ST STE B&C, LEESVILLE, LA 71446-4930
(337) 238-4350
(337) 238-4352
Mailing address
1000 CHINABERRY DR STE 900, BOSSIER CITY, LA 71111-2455
(318) 675-0804
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YP2500X
Professional Counselor
9277
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/14/2021
Last updated
02/03/2025
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