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General NPI Number Information
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NPI Number | 1972986743
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Entity Type | Organization
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Legal Business Name | CHRISTINE DESJARDINS, LLC
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Dates
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Enumeration Date | 06/29/2015
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Last Update Date | 06/29/2015
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Provider Practice Location Address
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Address Line | 4038 CANAL ST
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City | NEW ORLEANS
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State | LA
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Zip | 70119-6021
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Country | US
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Telephone | 504-313-8705
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 19581
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City | NEW ORLEANS
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State | LA
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Zip | 70179-0581
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Country | US
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Telephone | 504-313-8705
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. CHRISTINE DESJARDINS
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Credential | LPC
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Telephone | 504-313-8705
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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 | 5182
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License Number State | LA
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