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Individual

ELOUISE ROBERTSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1418 TIGER DR, THIBODAUX, LA 70301-4337
(985) 449-4055
(985) 449-4178
Mailing address
420 MAGNOLIA ST, HOUMA, LA 70360-6304
(985) 879-3966

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
8072
LA
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
05/07/2014
Last updated
06/19/2019
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