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General NPI Number Information
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NPI Number | 1861805491
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Entity Type | Organization
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Legal Business Name | DIVINE BEGINNINGS COUNSELING LLC
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Dates
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Enumeration Date | 06/11/2014
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Last Update Date | 06/11/2014
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Provider Practice Location Address
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Address Line | 3301 CALIFORNIA AVE
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City | KENNER
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State | LA
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Zip | 70065-3620
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Country | US
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Telephone | 504-382-8314
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Fax |
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Provider Business Mailing Address
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Address Line | 3301 CALIFORNIA AVE
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City | KENNER
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State | LA
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Zip | 70065-3620
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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 | DIRECTOR/CEO
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Name | DEMETRA THOMAS
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Credential |
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Telephone | 504-382-8314
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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 | 2896
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License Number State | LA
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