| Dana Duet-champagne, Llc | |
|
5001 Highway 190 East Service Rd Suite D-2, Office 2 Covington LA 70433-4930 | |
| (504) 250-7701 | |
| Not Available |
| Full Name | Dana Duet-champagne, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 5001 Highway 190 East Service Rd, Covington, Louisiana |
| Authorized Official Name and Position | Dana Duet-champagne (PRESIDENT) |
| Authorized Official Contact | 5042507701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dana Duet-champagne, Llc Po Box 549 Madisonville LA 70447-0549 Ph: (504) 250-7701 | Dana Duet-champagne, Llc 5001 Highway 190 East Service Rd Suite D-2, Office 2 Covington LA 70433-4930 Ph: (504) 250-7701 |
| NPI Number | 1861871584 |
|---|---|
| Provider Enumeration Date | 05/27/2015 |
| Last Update Date | 05/27/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861871584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 4726 (Louisiana) | Primary |
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