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1164926820
DORA WILTZ
LAKE CHARLES, LA
NPI
1164926820
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2018-03-19
Last Update Date
2018-05-09
Business Address
DORA WILTZ
1333 COMMON ST
LAKE CHARLES, LA 70601-5255
Phone number: 337-437-4014
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Mailing Address
DORA WILTZ
1333 COMMON ST
LAKE CHARLES, LA 70601-5255
Phone number: 337-437-4014
Copy
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