Individual
COREY GERARD PORCHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
708 JEFFERSON BLVD., LAFAYETTE, LA 70501
(337) 501-9869
Mailing address
708 JEFFERSON BLVD., LAFAYETTE, LA 70501
(337) 501-9869
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5357
LA
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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