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1073879649
MARK JUDE STANFORD
LAFAYETTE, LA
NPI
1073879649
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: LA 10658)
Enumeration Date
2012-04-07
Last Update Date
2012-04-07
Business Address
Mr. MARK JUDE STANFORD LCSW
1003 HUGH WALLIS RD S C-6
LAFAYETTE, LA 70508-2528
Phone number: 337-344-1617
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Mailing Address
Mr. MARK JUDE STANFORD LCSW
112 HOWARD AVE
LAFAYETTE, LA 70506-4402
Phone number: 337-344-1617
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