Provider Demographics
NPI:1548003882
Name:CREIGHTON, AFTAN
Entity type:Individual
Prefix:
First Name:AFTAN
Middle Name:
Last Name:CREIGHTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 126
Mailing Address - Street 2:
Mailing Address - City:CHARENTON
Mailing Address - State:LA
Mailing Address - Zip Code:70523-0126
Mailing Address - Country:US
Mailing Address - Phone:318-489-1579
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 126
Practice Address - Street 2:
Practice Address - City:CHARENTON
Practice Address - State:LA
Practice Address - Zip Code:70523-0126
Practice Address - Country:US
Practice Address - Phone:318-489-1579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)