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Individual
TINA CHAISSON
Active
Individual
TINA CHAISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2500
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11676401
CAQH
LA
05
—
793696000
—
LA
Enumeration date
08/19/2015
Last updated
08/19/2015
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