AMANDA EVETTE VITAL

LAKE CHARLES, LA
NPI1275039588
Former NameAMANDA EVETTE WILSON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2018-04-04
Last Update Date2018-04-04
Business Address
AMANDA EVETTE VITAL BGS, M.A.T., Ed.S.
1409 KIRKMAN ST
LAKE CHARLES, LA 70601-5344
Phone number: 337-419-3586
Mailing Address
AMANDA EVETTE VITAL BGS, M.A.T., Ed.S.
1409 KIRKMAN ST
LAKE CHARLES, LA 70601-5344
Phone number: 337-419-3586
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