Individual
THOMAS SHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CIT
Contact information
Practice address
5311 DIJON DR, BATON ROUGE, LA 70808-4314
(225) 300-4850
Mailing address
10502 N MYRTLELAKE AVE, BATON ROUGE, LA 70810-6638
(808) 222-9445
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5552
LA
Other
Enumeration date
07/06/2024
Last updated
07/06/2024
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