Individual
MISS CHRISTINA GRACE ELLENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CIT
Contact information
Practice address
3505 5TH AVE STE B, LAKE CHARLES, LA 70607-2156
(337) 475-4855
Mailing address
113 CASSY DR, SULPHUR, LA 70663-6555
(337) 475-4855
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/24/2008
Last updated
03/24/2008
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