Individual
CHRIS DARRELL RIDEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
311 MACARTHUR DR, SUNSET, LA 70584-6212
(337) 212-1629
Mailing address
PO BOX 236, SUNSET, LA 70584-0236
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157882652
—
LA
05
—
1578828851
—
LA
Enumeration date
02/15/2018
Last updated
02/15/2018
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