Individual
DA'JOUR BRAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED
Contact information
Practice address
2053 GAUSE BLVD E STE 150, SLIDELL, LA 70461-5451
(985) 649-1001
Mailing address
2053 GAUSE BLVD E STE 150, SLIDELL, LA 70461-5451
(985) 649-1001
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PLC9610
LA
171M00000X
Case Manager/Care Coordinator
012531787
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012531787
—
LA
Enumeration date
02/27/2023
Last updated
06/13/2023
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