Individual
MS. CONSTANCE EVANS ROMERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
800 JACKSON AVE, MANDEVILLE, LA 70448
(985) 778-1641
Mailing address
PO BOX 1501, MANDEVILLE, LA 70470
(985) 624-9786
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2125
LA
106H00000X
Marriage & Family Therapist
222
LA
Other
Enumeration date
04/03/2007
Last updated
12/12/2013
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