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Individual
BEAU S DANTIN
Active
Individual
BEAU S DANTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4770
LA
103TA0400X
Addiction (Substance Use Disorder) Psychologist
4770
LA
103TF0000X
Family Psychologist
Primary
4770
LA
106H00000X
Marriage & Family Therapist
4770
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000000
—
LA
Enumeration date
10/28/2014
Last updated
10/28/2014
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