Individual
MYRA D NOUSTENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
843 MILLING AVE, LULING, LA 70070-4442
(985) 785-5800
(985) 785-5811
Mailing address
3749 WHITEHALL DR, DESTREHAN, LA 70047-5055
(985) 307-0253
(985) 785-5804
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2864
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1409511
—
LA
Enumeration date
03/08/2006
Last updated
01/14/2008
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