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General NPI Number Information
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NPI Number | 1437409448
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Entity Type | Individual
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Provider Name | LATRINA R RADDLER M.ED, LPC-S
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Gender | Female
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Dates
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Enumeration Date | 09/17/2012
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 17023 AVOCET DR
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City | PRAIRIEVILLE
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State | LA
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Zip | 70769-4739
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Country | US
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Telephone | 225-421-9767
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Fax |
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Provider Business Mailing Address
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Address Line | 717 S FOSTER DR SUITE 130
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City | BATON ROUGE
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State | LA
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Zip | 70806-5943
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Country | US
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Telephone | 225-389-6110
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4510
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MHC.LH.61597761
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License Number State | WA
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