Individual
CONNIE ALPHONSO VIVERITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.I.T.
Contact information
Practice address
1229 CLIPPER DR, SLIDELL, LA 70458-5585
(504) 908-2664
Mailing address
1229 CLIPPER DR, SLIDELL, LA 70458-5585
(504) 908-2664
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
5420
LA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/31/2022
Last updated
02/20/2023
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