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Individual

HEATHER R PREJEAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
318 E PARK ST, CROWLEY, LA 70526-2468
(337) 258-5214
(337) 785-1188
Mailing address
240 THOROUGHBRED DR, LAFAYETTE, LA 70507-2562
(337) 258-5214
(337) 785-1188

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7244
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1793001
LA
01
5CG12
MEDICARE GROUP PTAN
Enumeration date
10/02/2007
Last updated
12/05/2012
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