Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | CI4531 | LA |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CIT3142 | LA |
NPI | 1003176744 |
---|---|
Provider Name | Mrs. Kimberly Lachney |
First Address | Lafayette, LA 70506-2871 |
Second Address | Lafayette, LA 70501-4740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2012 |
Last Update Date | 28/05/2012 |