Individual
DESTINIE FIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2937 GENERAL DOOLITTLE AVE, LAKE CHARLES, LA 70615-6920
(337) 419-3586
Mailing address
2937 GENERAL DOOLITTLE AVE, LAKE CHARLES, LA 70615-6920
(337) 419-3586
(855) 239-9737
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1889253
—
LA
Enumeration date
02/10/2016
Last updated
02/10/2016
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