Individual
NEDDESHA STALKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1960 FAITH PL # 2, TERRYTOWN, LA 70056-4200
(504) 338-9934
Mailing address
1960 FAITH PL # 2, TERRYTOWN, LA 70056-4200
(504) 338-9934
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/21/2016
Last updated
09/21/2016
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