Individual
JESSICA THEUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
169 BLANCHARD RD LOT 11, NATCHITOCHES, LA 71457-6270
(318) 730-4054
Mailing address
169 BLANCHARD RD LOT 11, NATCHITOCHES, LA 71457-6270
(318) 730-4044
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
LA
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
06/04/2017
Last updated
06/04/2017
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