Individual
ALYSE GUILLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
751 W BAYOU PINES DR, SUITE A, LAKE CHARLES, LA 70601-3600
(337) 433-3292
Mailing address
2525 YOUREE DR STE 110, SHREVEPORT, LA 71104-3600
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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