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General NPI Number Information
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NPI Number | 1710169412
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Entity Type | Organization
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Legal Business Name | ANOTHER CHANCE INC
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 12/04/2007
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Provider Practice Location Address
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Address Line | 1884 N 1ST STREET
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City | JENA
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State | LA
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Zip | 71342-2730
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Country | US
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Telephone | 318-992-2730
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Fax | 318-992-2730
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Provider Business Mailing Address
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Address Line | PO BOX 2027
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City | JENA
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State | LA
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Zip | 71342-2730
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Country | US
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Telephone | 318-992-2730
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Fax | 318-992-2730
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Authorized Official
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Title or Position | OWNER THERAPIST
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Name | MS. LAVERNE M PAUL
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Credential | LPC LMFT
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Telephone | 318-992-2730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1851
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License Number State | LA
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