1306151006 NPI number — WENDY QUIARA DURANT LPC

Table of content: WENDY QUIARA DURANT LPC (NPI 1306151006)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306151006 NPI number — WENDY QUIARA DURANT LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DURANT
Provider First Name:
WENDY
Provider Middle Name:
QUIARA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306151006
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4041 WILLIAMS BLVD
Provider Second Line Business Mailing Address:
SUITE A9-282
Provider Business Mailing Address City Name:
KENNER
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70065-3179
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-305-2250
Provider Business Mailing Address Fax Number:
504-305-2250

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1753 42ND ST
Provider Second Line Business Practice Location Address:
A
Provider Business Practice Location Address City Name:
KENNER
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70065-2183
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-305-2250
Provider Business Practice Location Address Fax Number:
504-305-2250
Provider Enumeration Date:
08/18/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  3955 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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