Individual
MS. TALLACE MADINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
3520 GENERAL DEGAULLE DR, NEW ORLEANS, LA 70114-6757
(504) 906-5457
Mailing address
PO BOX 7262, BELLE CHASSE, LA 70037-7262
(504) 906-5457
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5548
LA
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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