Healthcare Provider Details

I. General information

NPI: 1053169359
Provider Name (Legal Business Name): VERONICA EVETTE PRYOR-FACIANE PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2024
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1254 CENTRAL RD
BATON ROUGE LA
70807-3820
US

IV. Provider business mailing address

1254 CENTRAL RD
BATON ROUGE LA
70807-3820
US

V. Phone/Fax

Practice location:
  • Phone: 225-300-4943
  • Fax: 225-300-4899
Mailing address:
  • Phone: 225-267-7885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC10059
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: