Individual
MR. REGINALD GRACE SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
6225 PLANTATION DR., ST. GABRIEL, LA 70776
(225) 642-5104
(225) 642-5107
Mailing address
PO BOX 287, SAINT GABRIEL, LA 70776-0287
(225) 642-5104
(225) 642-5107
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
819
LA
Other
Enumeration date
03/20/2012
Last updated
03/20/2012
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