Individual
MRS. TYNESE HICKSON BREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
302 DULLES DR, LAFAYETTE, LA 70506-3008
(337) 262-4100
(337) 261-1146
Mailing address
302 DULLES DR, LAFAYETTE, LA 70506-3008
(337) 262-4100
(337) 261-1146
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8608
LA
Other
Enumeration date
01/30/2007
Last updated
03/26/2008
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