Individual
MRS. TYRETTE HERRINGTON BODINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1585 3RD ST BLDG 285, FORT POLK, LA 71459-5102
(337) 531-1766
Mailing address
109 NOAH HAYMON RD, LEESVILLE, LA 71446-8696
(337) 424-5473
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10254
LA
Other
Enumeration date
04/05/2012
Last updated
07/23/2024
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