Provider Demographics
NPI:1548409436
Name:DRACHENBERG, TANYA (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:DRACHENBERG
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 24236
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70184-4236
Mailing Address - Country:US
Mailing Address - Phone:504-342-5083
Mailing Address - Fax:504-486-8340
Practice Address - Street 1:3939 HOUMA BLVD BLDG 3
Practice Address - Street 2:SUITE 15 DOCTORS ROW
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2931
Practice Address - Country:US
Practice Address - Phone:504-342-5083
Practice Address - Fax:504-486-8340
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMFT-148106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist