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1285137968
THERESA M IVEY LLC
LAKE CHARLES, LA
NPI
1285137968
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Entity Type
Organization
Authorized Contact
THERESA IVEY
Owner
337-377-3011
Organization Subpart ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: LA 11372)
Enumeration Date
2018-03-09
Last Update Date
2018-03-09
Business Address
THERESA M IVEY LLC
133 JEFFERSON DR
LAKE CHARLES, LA 70605-5713
Phone number: 337-377-3011
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Mailing Address
THERESA M IVEY LLC
133 JEFFERSON DR
LAKE CHARLES, LA 70605-5713
Phone number: 337-377-3011
Copy
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