Individual
MS. REBA DIANNE CASEBOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRC, LAC, CI
Contact information
Practice address
13170 DUTCHTWN PT AVE APT 914, GONZALES, LA 70737-0104
(504) 458-0497
(800) 697-3631
Mailing address
13170 DUTCHTOWN POINT AVENUE #914, GONZALES, LA 70737-1317
(504) 458-0497
(800) 697-3631
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CRC00109065
LA
101Y00000X
Counselor
Primary
LAC1249
LA
Other
Enumeration date
11/04/2010
Last updated
11/04/2010
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