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1952867632
CARLISS G HOUSTON
THIBODAUX, LA
NPI
1952867632
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2019-02-18
Last Update Date
2019-02-18
Business Address
CARLISS G HOUSTON MEd
106 HICKORY ST
THIBODAUX, LA 70301-2008
Phone number: 985-446-4114
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Mailing Address
CARLISS G HOUSTON MEd
PO BOX 29
THIBODAUX, LA 70302-0029
Phone number: 985-446-4114
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