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1184155731
LADETRICK PROVO
BATON ROUGE, LA
NPI
1184155731
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2017-03-24
Last Update Date
2017-03-24
Business Address
-- LADETRICK PROVO
5476 SUMMER DR
BATON ROUGE, LA 70812-3046
Phone number: 225-333-7899
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Mailing Address
-- LADETRICK PROVO
5476 SUMMER DR
BATON ROUGE, LA 70812-3046
Phone number: 225-333-7899
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