Individual
MR. CHARLES BURCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH D
Contact information
Practice address
1581 CAROL SUE AVE, SUITE 211, GRETNA, LA 70056-5100
(504) 392-3498
(504) 392-4694
Mailing address
1581 CAROL SUE AVE, SUITE 211, GRETNA, LA 70056-5100
(504) 392-3498
(504) 392-4694
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
421
LA
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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