Provider Demographics
NPI:1235631177
Name:KIDDER, ALLISON CARA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:CARA
Last Name:KIDDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 N AVENUE L
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-3832
Mailing Address - Country:US
Mailing Address - Phone:337-788-3330
Mailing Address - Fax:337-788-4770
Practice Address - Street 1:713 N AVENUE L
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-3832
Practice Address - Country:US
Practice Address - Phone:337-788-3330
Practice Address - Fax:337-788-4770
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA86181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical