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Individual

CHARMAINE LANDRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CAC, CCDP

Contact information

Practice address
3505 5TH AVE STE B, LAKE CHARLES, LA 70607-2156
(337) 475-4855
Mailing address
1361 SADDLEWOOD DR, LAKE CHARLES, LA 70615-5350
(337) 436-1760

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1033
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
2026
LA

Other

Enumeration date
09/04/2009
Last updated
09/04/2009
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