Individual
CARDETRA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-BACS
Contact information
Practice address
1724 N BURNSIDE AVE STE 7, GONZALES, LA 70737-2157
(225) 323-5996
(225) 644-6261
Mailing address
PO BOX 541, GEISMAR, LA 70734-0541
(225) 323-5996
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6083
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1807869
—
LA
Enumeration date
12/01/2015
Last updated
12/01/2015
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