Provider Demographics
NPI:1043840374
Name:TUESNO, CETERA
Entity type:Individual
Prefix:
First Name:CETERA
Middle Name:
Last Name:TUESNO
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 109
Mailing Address - Street 2:
Mailing Address - City:WEYANOKE
Mailing Address - State:LA
Mailing Address - Zip Code:70787-0109
Mailing Address - Country:US
Mailing Address - Phone:225-421-6866
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 109
Practice Address - Street 2:
Practice Address - City:WEYANOKE
Practice Address - State:LA
Practice Address - Zip Code:70787-0109
Practice Address - Country:US
Practice Address - Phone:225-421-6866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-26
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA102L00000X, 171M00000X
103K00000X
AL6568G104100000X
ID2761577104100000X
LA141781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator