Provider Information for 1134472673
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Prof. MARCELL MEAUX GARY LPC-S
Sex: Female
NPI: 1134472673
Last Updated: 2018-07-05
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1134472673 | ||||||||
| Enumeration Date | 2012-10-22 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2224 ROXTON ST SULPHUR, LA 70663-7237 United States Phone: 337-802-6494 | Fax: | ||||||||
| Primary Practice Address | 2119 OAK PARK BLVD LAKE CHARLES, LA 70601 United States Phone: 337-497-0034 | Fax: | ||||||||
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