Individual
LANTRELLE L NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
203 PAUL MAILLARD RD, LULING, LA 70070-4203
(504) 401-1530
Mailing address
PO BOX 612, SAINT ROSE, LA 70087-0612
(504) 401-1530
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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