Individual
WAKANDA MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP-BC
Contact information
Practice address
1450B PETERMAN DR, ALEXANDRIA, LA 71301-3432
(318) 299-2950
Mailing address
PO BOX 3352, PINEVILLE, LA 71361-3352
(318) 299-2950
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
208238
LA
Other
Enumeration date
08/21/2019
Last updated
09/01/2022
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