Individual
KALVIN DEHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
163 ESSENCE AVE, THIBODAUX, LA 70301-5900
(985) 860-4908
Mailing address
163 ESSENCE AVE, THIBODAUX, LA 70301-5900
(985) 860-4908
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6296
LA
101YP2500X
Professional Counselor
Primary
6296
LA
Other
Enumeration date
06/15/2018
Last updated
08/08/2022
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