STACEY GRACE WILLSON

LAFAYETTE, LA
NPI1134177678
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: LA  3156)
Additional Taxonomies1041C0700X Social Worker, Clinical
(Licence: TX  37976)
Enumeration Date2006-05-05
Last Update Date2007-07-08
Business Address
-- STACEY GRACE WILLSON LCSW
200 N LAKEPOINTE DR
LAFAYETTE, LA 70506-6431
Phone number: 337-412-8048
Mailing Address
-- STACEY GRACE WILLSON LCSW
200 N LAKEPOINTE DR
LAFAYETTE, LA 70506-6431
Phone number: 337-412-8048