Individual
LISA S RIVARDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2836 FRONT ST., SLIDELL, LA 70458
(504) 577-7103
Mailing address
3628 MEADOWDALE DR, SLIDELL, LA 70458
(504) 577-7103
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3892
LA
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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