Provider Demographics
NPI:1588808182
Name:DELERNO, CHARLES CHAILLE (CERT HYPNOTHERAPIST)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:CHAILLE
Last Name:DELERNO
Suffix:
Gender:M
Credentials:CERT HYPNOTHERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1736 AUDUBON ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-5504
Mailing Address - Country:US
Mailing Address - Phone:504-861-1924
Mailing Address - Fax:
Practice Address - Street 1:1736 AUDUBON ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5504
Practice Address - Country:US
Practice Address - Phone:504-861-1924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2473429001174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist