MARK JUDE STANFORD

LAFAYETTE, LA
NPI1073879649
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: LA  10658)
Enumeration Date2012-04-07
Last Update Date2012-04-07
Business Address
Mr. MARK JUDE STANFORD LCSW
1003 HUGH WALLIS RD S C-6
LAFAYETTE, LA 70508-2528
Phone number: 337-344-1617
Mailing Address
Mr. MARK JUDE STANFORD LCSW
112 HOWARD AVE
LAFAYETTE, LA 70506-4402
Phone number: 337-344-1617