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NPI Code Detail

MEDICARE: RACHEAL G SUTHERLAND CIT

MEDICARE: RACHEAL G SUTHERLAND CIT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor4138LA

General Provider Information

NPI Number : 1265097836
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEAL G SUTHERLAND CIT
Provider Business Mailing Address
First Line : 216 S FOSTER DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-4103
Country : US
Telephone Number : 225-925-5367
Fax Number :
Provider Business Practice Location Address
First Line : 216 S FOSTER DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-4103
Country : US
Telephone Number : 225-925-5367
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2019
Last Update Date : 05/08/2019

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Directions to “ RACHEAL G SUTHERLAND CIT” Practice Location

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