Organization
LAKE AREA TMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHAETRA RANEY ED.D, LCSW (CEO)
(832) 363-7877
Entity
Organization
Contact information
Practice address
1 LAKESHORE DR STE 130, LAKE CHARLES, LA 70629-0100
(832) 363-7877
Mailing address
19901 SOUTHWEST FWY, SUGAR LAND, TX 77479-6538
(832) 363-7877
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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