Individual
MRS. THETA H EGNEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1406A GAUSE BLVD, SLIDELL, LA 70458
(985) 781-0548
(985) 781-4319
Mailing address
77 SHADY LANE DR., SLIDELL, LA 70460
(985) 640-1138
(985) 781-4319
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1266
LA
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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