Provider Demographics
NPI:1821750381
Name:TERREBONNE, MARIANNE ANTOINETTE (LPC-S, LMFT)
Entity Type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:ANTOINETTE
Last Name:TERREBONNE
Suffix:
Gender:F
Credentials:LPC-S, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 BROADWAY DR.
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70053-5037
Mailing Address - Country:US
Mailing Address - Phone:504-361-1999
Mailing Address - Fax:
Practice Address - Street 1:202 BROADWAY DR.
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-5037
Practice Address - Country:US
Practice Address - Phone:504-361-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA202106H00000X
LA710101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist