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General NPI Number Information
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NPI Number | 1750774972
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Entity Type | Organization
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Legal Business Name | DEVOTED TO CHANGE GRADUALLY LLC
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 03/12/2015
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Provider Practice Location Address
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Address Line | 5266 ANNUNCIATION ST
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City | NEW ORLEANS
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State | LA
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Zip | 70115-1848
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Country | US
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Telephone | 504-554-8681
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Fax | 504-309-7845
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Provider Business Mailing Address
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Address Line | 5266 ANNUNCIATION ST
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City | NEW ORLEANS
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State | LA
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Zip | 70115-1848
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Country | US
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Telephone | 504-236-4358
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Fax | 504-309-7845
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LAURIE SANCHEZ
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Credential |
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Telephone | 504-309-7844
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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 | 6501
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License Number State | LA
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