Doctor Name: | KAYLA S FANGUY |
NPI Number: | 1104145507 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC, LMFT |
License Number: | 3986 |
Business Practice Address: | 4540 Ambassador Caffery Pkwy Bldg. D, Suite B-220 Lafayette, LA - 705086928 |
Business Phone Number: | 3379812180 |
Business Fax Number: | 3379812391 |
Mailing Address: | 4540 Ambassador Caffery Pkwy, Bldg. D, Suite B-220 LAFAYETTE |
State: | LA |
Postal Code: | 705086928 |
Phone Number: | 3379812180 |
Fax Number: | 3379812391 |
NPI Enumeration Date: | 05/25/2010 |
NPI Last Update Date: | 05/25/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 3986 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |