Individual
JOHN ANTONUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
2420 ATHANIA PKWY STE 102, METAIRIE, LA 70001-1975
(504) 810-9535
Mailing address
2119 PINE ST, NEW ORLEANS, LA 70118-5416
(504) 810-9535
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1435
LA
101YP2500X
Professional Counselor
Primary
6597
LA
Other
Enumeration date
02/06/2017
Last updated
01/07/2019
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