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Individual

SKYI VINCENT BORDELON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
216 ACORN DR, LAFAYETTE, LA 70507-4204
(337) 501-6175
Mailing address
216 ACORN DR, LAFAYETTE, LA 70507-4204

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4664
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4664
LPC BOARD OF EXAMINERS
LA
Enumeration date
01/28/2019
Last updated
01/28/2019
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