Individual
KATHLEEN ROSE CANTERBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
145 VICTORIA DR, LAKE CHARLES, LA 70611-4641
(337) 855-9773
Mailing address
145 VICTORIA DR, LAKE CHARLES, LA 70611-4641
(337) 855-9773
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4161
LA
Other
Enumeration date
11/29/2018
Last updated
11/29/2018
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