CHAD FREDERICK

RUSTON, LA
NPI1417362278
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA  3129)
Enumeration Date2014-06-30
Last Update Date2014-06-30
Business Address
-- CHAD FREDERICK
617 S TRENTON ST
RUSTON, LA 71270-5040
Phone number: 318-251-4659
Mailing Address
-- CHAD FREDERICK
617 S TRENTON ST
RUSTON, LA 71270-5040
Phone number: 318-251-4659
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