Individual provider · Type 1 NPI
Mary Janelle Disney, PhD
Professional Counselor · Lake Charles, LA
NPI number
1750540332
Active
Practice location
840 West Bayou Pines, Suite B
Lake Charles, LA 70601
Fax (337) 310-0202
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 238 (LA) |
| Professional Counselor | 101YP2500X | LPC001933 (GA) |
| Marriage & Family Therapist | 106H00000X | MFT127 (LA) |
Professional Counselor: Definition to come...
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About NPI 1750540332
Mary Janelle Disney, PhD's National Provider Identifier is 1750540332, issued on Jun 9, 2008. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Lake Charles, LA. The record was last updated on Jun 9, 2008.