Provider Demographics
NPI:1053169359
Name:PRYOR-FACIANE, VERONICA EVETTE (PLPC)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:EVETTE
Last Name:PRYOR-FACIANE
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1254 CENTRAL RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70807-3820
Mailing Address - Country:US
Mailing Address - Phone:225-267-7885
Mailing Address - Fax:
Practice Address - Street 1:1254 CENTRAL RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70807-3820
Practice Address - Country:US
Practice Address - Phone:225-300-4943
Practice Address - Fax:225-300-4899
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC10059101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health