Individual
COLIN BREA THERIOT HANOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., NCC, LPC
Contact information
Practice address
850 KALISTE SALOOM RD STE 219, LAFAYETTE, LA 70508-4230
(337) 504-4974
(337) 456-2434
Mailing address
31301 LA HWY 3143, GUEYDAN, LA 70542-5652
(337) 230-3842
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6468
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3485761
—
LA
Enumeration date
08/11/2020
Last updated
09/08/2022
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