Individual
KENTRELL BLATCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
3084 WESTFORK DR STE B, BATON ROUGE, LA 70816-2254
(504) 430-8685
(225) 246-8507
Mailing address
7726 N JEFFERSON PLACE CIR APT I, BATON ROUGE, LA 70809-8622
(504) 430-8685
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5099
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3249341
—
LA
Enumeration date
09/07/2016
Last updated
05/25/2022
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