MARK SHANE ANDERSON

LAKE CHARLES, LA
NPI1184825705
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA  2251 CIT)
Enumeration Date2007-05-30
Last Update Date2011-09-23
Business Address
Mr. MARK SHANE ANDERSON RAC, CCDP, CCGC
4105 KIRKMAN ST
LAKE CHARLES, LA 70607-4603
Phone number: 337-475-8738
Mailing Address
Mr. MARK SHANE ANDERSON RAC, CCDP, CCGC
811 FALL ST
LAKE CHARLES, LA 70601-8659
Phone number: 337-433-4475
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