Individual
DR. CHARLES ALFRED GAGNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED. D., LPC-A
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1973
LA
101YP2500X
Professional Counselor
72518
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1973
LPC STATE LICENSE
LA
01
—
33683
NTNL. CERT. COUNSELOR
—
Enumeration date
10/21/2005
Last updated
09/20/2022
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