Individual
MRS. TRESA MCKOIN MOYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC
Contact information
Practice address
320 S FRANKLIN ST, BASTROP, LA 71220-4539
(318) 556-7040
(318) 283-0875
Mailing address
15247 LAKESHORE DR, BONITA, LA 71223-9670
(318) 823-3077
(318) 823-3077
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1324
LA
Other
Enumeration date
01/17/2012
Last updated
01/17/2012
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