Provider Demographics
NPI:1467783498
Name:GUIDRY, RONAD CHARLES JR
Entity Type:Individual
Prefix:MR
First Name:RONAD
Middle Name:CHARLES
Last Name:GUIDRY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 GEN DE GAULLE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-6756
Mailing Address - Country:US
Mailing Address - Phone:504-390-8198
Mailing Address - Fax:504-365-1011
Practice Address - Street 1:3201 GEN DE GAULLE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-6756
Practice Address - Country:US
Practice Address - Phone:504-390-8198
Practice Address - Fax:504-365-1011
Is Sole Proprietor?:No
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral