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Individual

CAROL CHEYENNE VERMILLION

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
2711 ERNEST ST, LAKE CHARLES, LA 70601-8406
(337) 431-7194
Mailing address
2711 ERNEST ST, LAKE CHARLES, LA 70601-8406
(337) 431-7194

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5722
LA

Other

Enumeration date
11/11/2015
Last updated
11/11/2015
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