Individual
EMOGENE BRUINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1715 ASHLEY AVE STE A, ALEXANDRIA, LA 71301-7344
(318) 625-7571
(844) 317-5579
Mailing address
4802 CONNELLA DR, ALEXANDRIA, LA 71302-2607
(318) 445-2645
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902256886
—
LA
Enumeration date
04/05/2018
Last updated
06/16/2018
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