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Individual

MS. BERNETTA V VICTORIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAC, CCGC

Contact information

Practice address
220 S MARKET ST, OPELOUSAS, LA 70570-5140
(337) 948-0226
(337) 948-0303
Mailing address
220 S MARKET ST, OPELOUSAS, LA 70570-5140
(337) 948-0226
(337) 948-0303

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LAC 817
LA
101YP2500X
Professional Counselor
CCGC 1005
LA

Other

Enumeration date
02/13/2012
Last updated
01/14/2019
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