Provider Demographics
NPI:1619235454
Name:NAQUIN, ALYCEE M (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:ALYCEE
Middle Name:M
Last Name:NAQUIN
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 COLLEGE LN
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-3704
Mailing Address - Country:US
Mailing Address - Phone:985-791-7012
Mailing Address - Fax:
Practice Address - Street 1:1340 W TUNNEL BLVD
Practice Address - Street 2:SUITE 330
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2801
Practice Address - Country:US
Practice Address - Phone:985-876-8630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4162101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional