Individual
MRS. SHANNON ARDOIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
145 VICTORIA DR, LAKE CHARLES, LA 70611-4641
(337) 855-9773
Mailing address
145 VICTORIA DR, LAKE CHARLES, LA 70611-4641
(337) 855-9773
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1378
ADRA
LA
01
—
183
ADRA
LA
Enumeration date
07/03/2017
Last updated
03/09/2022
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