Individual
MISS CHRISTY MICHELLE DENICOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11990 JACKSON ST, CLINTON, LA 70722-3210
(225) 683-5292
(225) 683-1310
Mailing address
PO BOX 395, CLINTON, LA 70722-0395
(225) 683-5292
(225) 222-6543
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5502
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031445
—
LA
Enumeration date
09/11/2007
Last updated
03/26/2019
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