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Individual

LISA KATE LANDRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BS, CIT

Contact information

Practice address
100 POYDRAS ST, LAFAYETTE, LA 70501-4740
(337) 231-6365
(337) 231-6371
Mailing address
100 POYDRAS ST, LAFAYETTE, LA 70501-4740
(337) 231-6365
(337) 231-6371

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4150
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023459559
LA
Enumeration date
02/05/2019
Last updated
02/05/2019
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