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Individual

JESSICA CHOWDHURY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2711 ERNEST ST, LAKE CHARLES, LA 70601-8406
(337) 431-7194
(337) 431-7198
Mailing address
2711 ERNEST ST, LAKE CHARLES, LA 70601-8406
(337) 431-7194
(337) 431-7198

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1649929
LA
Enumeration date
11/11/2015
Last updated
05/11/2018
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