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General NPI Number Information
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NPI Number | 1528438777
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Entity Type | Individual
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Provider Name | ANDREE CREDO
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Gender | Female
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 12/11/2020
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Provider Practice Location Address
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Address Line | 3616 S I 10 SERVICE RD W STE 200
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City | METAIRIE
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State | LA
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Zip | 70001
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Country | US
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Telephone | 504-535-2430
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Fax |
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Provider Business Mailing Address
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Address Line | 3616 S I 10 SERVICE RD W STE 200
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City | METAIRIE
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State | LA
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Zip | 70001-1874
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5110
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License Number State | LA
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