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Individual

MRS. TANESIA MANIQUE JAMES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3505 5TH AVE, LAKE CHARLES, LA 70607-2156
(337) 475-4855
(337) 475-4858
Mailing address
4464 GORDON WOODS DR, LAKE CHARLES, LA 70615-2995
(337) 475-4855

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
01/28/2010
Last updated
01/28/2010
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