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General NPI Number Information
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NPI Number | 1235538968
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Entity Type | Individual
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Provider Name | QUINTEN DRONET LAC ICADC
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Gender | Male
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 08/19/2014
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Provider Practice Location Address
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Address Line | 10631 HWY 71 S
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City | CHENEYVILLE
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State | LA
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Zip | 71325
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Country | US
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Telephone | 318-279-2751
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Fax | 318-279-2755
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Provider Business Mailing Address
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Address Line | 10267 HWY 71S
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City | CHENEYVILLE
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State | LA
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Zip | 71325
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Country | US
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Telephone | 318-279-2751
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Fax | 318-279-2755
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LAC 1474
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License Number State | LA
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