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General NPI Number Information
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NPI Number | 1871832717
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Entity Type | Individual
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Provider Name | GLENN MICHAEL TREGRE JR. LPC
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Gender | Male
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Dates
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Enumeration Date | 02/13/2013
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Last Update Date | 02/13/2013
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Provider Practice Location Address
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Address Line | 3520 GENERAL DEGAULLE DR SUITE 4070
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City | NEW ORLEANS
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State | LA
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Zip | 70114-6757
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Country | US
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Telephone | 504-363-7449
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Fax | 504-363-7077
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Provider Business Mailing Address
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Address Line | 3594 KENMORE DR
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City | PAULINA
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State | LA
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Zip | 70763-2312
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Country | US
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Telephone | 504-253-1278
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3864
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License Number State | LA
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