Doctor Name: | MRS. TRUDY MCLAIN |
NPI Number: | 1114228616 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 72-6011595 |
Business Practice Address: | 2106 Avenue F Bogalusa, LA - 704275027 |
Business Phone Number: | 9857326655 |
Business Fax Number: | 9857326678 |
Mailing Address: | 263 Devon Dr, MANDEVILLE |
State: | LA |
Postal Code: | 704483407 |
Phone Number: | 9856266092 |
Fax Number: | |
NPI Enumeration Date: | 11/15/2010 |
NPI Last Update Date: | 11/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 72-6011595 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |