Provider Demographics
NPI:1376095919
Name:TROSCLAIR, CYNTHIA A
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:TROSCLAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 COLUMBUS ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-4306
Mailing Address - Country:US
Mailing Address - Phone:985-232-2621
Mailing Address - Fax:
Practice Address - Street 1:3821 HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:RACELAND
Practice Address - State:LA
Practice Address - Zip Code:70394-3146
Practice Address - Country:US
Practice Address - Phone:985-537-6776
Practice Address - Fax:985-537-6779
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA101YM0800XMedicaid