Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | LA |
NPI | 1003338534 |
---|---|
Provider Name | Ms. Keyorka K Dennis |
First Address | La Place, LA 70068-6512 |
Second Address | La Place, LA 70068-6512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2017 |
Last Update Date | 08/05/2019 |