Individual
LAQUONDA BURISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1410 CREED ST, PINEVILLE, LA 71360
(318) 730-6387
Mailing address
1410 CREED ST, PINEVILLE, LA 71360
(318) 730-6387
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
008658532
LA
Other
Enumeration date
11/02/2015
Last updated
08/01/2019
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