Individual
DEBRA SPRUEL CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
6962 TITIAN AVE APT 7, BATON ROUGE, LA 70806-2749
(225) 284-7025
Mailing address
6962 TITIAN AVE APT 7, BATON ROUGE, LA 70806-2749
(225) 284-7025
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
DC860062
LA
103TP2701X
Group Psychotherapy Psychologist
Primary
DC860062
LA
171M00000X
Case Manager/Care Coordinator
DC860062
LA
Other
Enumeration date
12/21/2022
Last updated
12/21/2022
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