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Individual

MR. RONALD WAYON HINES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BS. LAC, AADC, CCS

Contact information

Practice address
100 POYDRAS ST, LAFAYETTE, LA 70501-4740
(337) 231-6365
Mailing address
100 POYDRAS ST, LAFAYETTE, LA 70501-4740
(337) 231-6365

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
311
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
311
ADRA
LA
Enumeration date
11/25/2015
Last updated
11/25/2015
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