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General NPI Number Information
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NPI Number | 1720390495
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Entity Type | Organization
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Legal Business Name | CENTER FOR PERSONAL DEVELOPMENT INC
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Dates
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Enumeration Date | 07/09/2010
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 409 SHERIDAN AVE
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City | MONROE
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State | LA
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Zip | 71201-5127
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Country | US
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Telephone | 318-361-0590
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Fax | 318-600-4985
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Provider Business Mailing Address
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Address Line | PO BOX 4381
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City | MONROE
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State | LA
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Zip | 71211-4381
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Country | US
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Telephone | 318-361-0590
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Fax | 318-600-4985
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LORIA SHELA PIERCE
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Credential | LMFT
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Telephone | 318-512-1257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 27028
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License Number State | LA
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