Individual
LUCILLE TISBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC
Contact information
Practice address
501 W SAINT MARY BLVD STE 414, LAFAYETTE, LA 70506-4600
(337) 706-5020
Mailing address
10473 OLD HAMMOND HWY, BATON ROUGE, LA 70816-8264
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1200
LA
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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