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1932770948
MICKIE DAVINA WOODALL
SLIDELL, LA
NPI
1932770948
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: LA 221224)
Enumeration Date
2021-07-09
Last Update Date
2021-07-09
Business Address
MICKIE DAVINA WOODALL PMHNP
113 CHRISTIAN LN
SLIDELL, LA 70458-1377
Phone number: 504-575-3712
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Mailing Address
MICKIE DAVINA WOODALL PMHNP
2900 INDIANA AVE
KENNER, LA 70065-4605
Phone number: 504-575-3712
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