Provider Demographics
NPI:1982075370
Name:CHRISTIAN, D'JANERO (COTA)
Entity type:Individual
Prefix:MRS
First Name:D'JANERO
Middle Name:
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 AUTUMN WOODS DR
Mailing Address - Street 2:
Mailing Address - City:LACOMBE
Mailing Address - State:LA
Mailing Address - Zip Code:70445-6256
Mailing Address - Country:US
Mailing Address - Phone:318-801-4436
Mailing Address - Fax:
Practice Address - Street 1:188 AUTUMN WOODS DR
Practice Address - Street 2:
Practice Address - City:LACOMBE
Practice Address - State:LA
Practice Address - Zip Code:70445-6256
Practice Address - Country:US
Practice Address - Phone:318-801-4436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-12
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LA8748101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care Coordinator