Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 610 | LA |
Y | 101YP2500X | Professional Counselor | 2277 | LA |
NPI | 1003869611 |
---|---|
Provider Name | Christine Lerille Mcgill |
First Address | Lafayette, LA 70503-3414 |
Second Address | Lafayette, LA 70503-3414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 21/09/2015 |