Individual
MS. MILDRED V DEBARGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1709 W PRIEN LAKE RD, LAKE CHARLES, LA 70601-8360
(337) 475-2557
(337) 266-5157
Mailing address
1709 W PRIEN LAKE RD, LAKE CHARLES, LA 70601-8360
(337) 475-2557
(337) 266-5157
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
350
LA
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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