Provider Demographics
NPI:1629725023
Name:JEANSONNE, TARALAH
Entity type:Individual
Prefix:
First Name:TARALAH
Middle Name:
Last Name:JEANSONNE
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 341
Mailing Address - Street 2:
Mailing Address - City:PINE PRAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70576-0341
Mailing Address - Country:US
Mailing Address - Phone:409-853-8568
Mailing Address - Fax:
Practice Address - Street 1:306 W MAIN ST
Practice Address - Street 2:
Practice Address - City:VILLE PLATTE
Practice Address - State:LA
Practice Address - Zip Code:70586-4420
Practice Address - Country:US
Practice Address - Phone:337-506-2294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-05
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional