Healthcare Provider Details

I. General information

NPI: 1679488431
Provider Name (Legal Business Name): BIANCA A PETERS CIT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 OLD STERLINGTON RD UNIT 17
STERLINGTON LA
71280-3531
US

IV. Provider business mailing address

2120 OLD STERLINGTON RD UNIT 17
STERLINGTON LA
71280-3531
US

V. Phone/Fax

Practice location:
  • Phone: 318-351-9808
  • Fax:
Mailing address:
  • Phone: 318-351-9808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number6167
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: