MEDICARE: MR. RONAD CHARLES GUIDRY JR.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor
3	103TB0200X	Cognitive & Behavioral Psychologist

General Provider Information

NPI Number	:	1467783498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RONAD CHARLES GUIDRY JR.

Provider Business Mailing Address
First Line	:	3201 GEN DE GAULLE DR
Second Line	:	SUITE 101
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-6756
Country	:	US
Telephone Number	:	504-390-8198
Fax Number	:	504-365-1011

Provider Business Practice Location Address
First Line	:	3201 GEN DE GAULLE DR
Second Line	:	SUITE 101
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-6756
Country	:	US
Telephone Number	:	504-390-8198
Fax Number	:	504-365-1011

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2010
Last Update Date	:	01/14/2010

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