Provider Demographics
NPI:1639649759
Name:ANDERSON, RACHEL SHARON
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:SHARON
Last Name:ANDERSON
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 1:200 UNION ST
Mailing Address - Street 2:
Mailing Address - City:MONTZ
Mailing Address - State:LA
Mailing Address - Zip Code:70068-9042
Mailing Address - Country:US
Mailing Address - Phone:504-209-1500
Mailing Address - Fax:
Practice Address - Street 1:200 UNION ST
Practice Address - Street 2:
Practice Address - City:MONTZ
Practice Address - State:LA
Practice Address - Zip Code:70068-9042
Practice Address - Country:US
Practice Address - Phone:504-209-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-01
Last Update Date:2018-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health