Individual
MARY JANELLE DISNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
840 WEST BAYOU PINES, SUITE B, LAKE CHARLES, LA 70601
(337) 310-0153
(337) 310-0202
Mailing address
840 WEST BAYOU PINES, SUITE B, LAKE CHARLES, LA 70601
(337) 310-0153
(337) 310-0202
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
238
LA
101YP2500X
Professional Counselor
LPC001933
GA
106H00000X
Marriage & Family Therapist
MFT127
LA
Other
Enumeration date
06/09/2008
Last updated
06/09/2008
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