Individual
CLARISSA THIERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2163 74TH AVE, BATON ROUGE, LA 70807-5929
(225) 205-0457
Mailing address
2163 74TH AVE, BATON ROUGE, LA 70807-5929
(225) 205-0457
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YM0800X
LA
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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