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General NPI Number Information
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NPI Number | 1205256302
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Entity Type | Organization
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Legal Business Name | LAINIE BREAUX, LLC
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Dates
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Enumeration Date | 04/16/2014
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 3500 N CAUSEWAY BLVD SUITE 1410
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City | METAIRIE
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State | LA
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Zip | 70002-3527
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Country | US
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Telephone | 504-838-9919
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Fax | 504-834-3101
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Provider Business Mailing Address
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Address Line | 3500 N CAUSEWAY BLVD SUITE 1410
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City | METAIRIE
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State | LA
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Zip | 70002-3527
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Country | US
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Telephone | 504-838-9919
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Fax | 504-834-3101
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Authorized Official
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Title or Position | OWNER
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Name | MRS. HELENE WALTZER BREAUX
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Credential | LCSW
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Telephone | 504-838-9919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 5126
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License Number State | LA
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