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General NPI Number Information
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NPI Number | 1831854868
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC SOLUTIONS OF CENTRAL LOUISIANA LLC
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Dates
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Enumeration Date | 11/04/2021
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Last Update Date | 11/04/2021
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Provider Practice Location Address
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Address Line | 5401 JACKSON ST STE B
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City | ALEXANDRIA
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State | LA
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Zip | 71303-2595
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Country | US
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Telephone | 318-265-7134
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Fax |
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Provider Business Mailing Address
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Address Line | 405 SKYBLUE DR
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City | PINEVILLE
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State | LA
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Zip | 71360-9002
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Country | US
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Telephone | 318-485-9149
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH SIMON-CLARK
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Credential |
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Telephone | 318-485-9149
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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 |
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License Number State |
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