Provider Demographics
NPI:1093964686
Name:PRICE, ALLISON (GSW)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:GSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 W AIRLINE HWY STE L
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-3820
Mailing Address - Country:US
Mailing Address - Phone:985-651-7064
Mailing Address - Fax:985-651-7067
Practice Address - Street 1:421 W AIRLINE HWY STE L
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-3820
Practice Address - Country:US
Practice Address - Phone:985-651-7064
Practice Address - Fax:985-651-7067
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9944104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker