ALICIA FONDA MALLETT

LAKE CHARLES, LA
NPI1861051310
Professional NameFONDA PRADO MALLETT
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy235Z00000X Speech-Language Pathologist
(Licence: LA  7029)
Enumeration Date2019-06-09
Last Update Date2019-06-09
Business Address
MRS. ALICIA FONDA MALLETT
1128 HIDDEN OAK LN
LAKE CHARLES, LA 70605-7123
Phone number: 337-794-2744
Mailing Address
MRS. ALICIA FONDA MALLETT
1128 HIDDEN OAK LN
LAKE CHARLES, LA 70605-7123
Phone number: 337-794-2744
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