Provider Demographics
NPI:1730612334
Name:READO, CHERCHEZE
Entity type:Individual
Prefix:
First Name:CHERCHEZE
Middle Name:
Last Name:READO
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 1:6116 INGRAM DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70812-2329
Mailing Address - Country:US
Mailing Address - Phone:225-978-5836
Mailing Address - Fax:225-479-9533
Practice Address - Street 1:3968 NORTH BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3826
Practice Address - Country:US
Practice Address - Phone:225-478-9533
Practice Address - Fax:225-478-9534
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor