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1154873388
ALICIAH KAE SOUZA
BASTROP, LA
NPI
1154873388
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: LA 471411453)
Enumeration Date
2016-11-04
Last Update Date
2016-11-04
Business Address
-- ALICIAH KAE SOUZA B.S.
644 E JEFFERSON AVE
BASTROP, LA 71220-4619
Phone number: 318-239-3862
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Mailing Address
-- ALICIAH KAE SOUZA B.S.
810 E PECAN AVE
BASTROP, LA 71220-5124
Phone number: 310-974-3055
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