Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | CBC-236 | LA |
Y | 101YP2500X | Professional Counselor | 4927 | LA |
NPI | 1083031488 |
---|---|
Provider Name | Dr. Leonard Tennart |
First Address | Baton Rouge, LA 70815-6230 |
Second Address | Baton Rouge, LA 70805-7518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2014 |
Last Update Date | 24/03/2014 |