Individual
MRS. BAMBI LORETTA HARDESTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CIT
Contact information
Practice address
2110 OAK PARK BLVD, LAKE CHARLES, LA 70601-7864
(337) 936-2525
Mailing address
2110 OAK PARK BLVD, LAKE CHARLES, LA 70601-7864
(337) 936-2525
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CIT-5650
LA
Other
Enumeration date
07/26/2023
Last updated
07/26/2023
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