Individual
CHARLI RHEA DEROUEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAC, CCS
Contact information
Practice address
406 SAINT JULIEN AVE, LAFAYETTE, LA 70506-4622
(337) 366-6050
Mailing address
406 SAINT JULIEN AVE, LAFAYETTE, LA 70506-4622
(337) 366-6050
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3384
LA
Other
Enumeration date
03/30/2023
Last updated
03/30/2023
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