Individual
LORRAINE NICOLE DURISSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC-MHSP
Contact information
Practice address
1635 CHESTNUT ST, CHATTANOOGA, TN 37408-1024
(877) 258-8795
Mailing address
1635 CHESTNUT ST, CHATTANOOGA, TN 37408-1024
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2693
TN
101YP2500X
Professional Counselor
Primary
2693
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q010986
—
TN
Enumeration date
03/15/2011
Last updated
05/06/2016
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