Individual
BENJAMIN LARISEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1798 HIGHWAY 1042, GREENSBURG, LA 70441-4241
(225) 306-2097
Mailing address
PO BOX 770, ZACHARY, LA 70791-0770
(225) 306-2000
(225) 658-1282
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11772
LA
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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