Individual
DERESHA BEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1615 POYDRAS ST, STE. 902, NEW ORLEANS, LA 70112-1254
(504) 648-6820
Mailing address
7450 NORTHGATE DR, NEW ORLEANS, LA 70128-2326
(281) 204-3624
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558649087
—
LA
Enumeration date
09/02/2016
Last updated
09/02/2016
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