Organization
BREALON LIRETTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BREALON M LIRETTE APRN (OWNER)
(985) 804-0678
Entity
Organization
Contact information
Practice address
242 WOODWIND DR, HOUMA, LA 70360-3996
(337) 643-8424
(337) 643-8407
Mailing address
242 WOODWIND DR, HOUMA, LA 70360-3996
(337) 643-8424
(337) 643-8407
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2456067
—
LA
Enumeration date
09/11/2018
Last updated
04/27/2020
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