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Individual

GWENDOLYN BYNUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PLPC

Contact information

Practice address
2101 TOWER DR, MONROE, LA 71201-5045
(318) 884-3905
Mailing address
1162 OLIVER RD STE 4, MONROE, LA 71201-5757
(318) 340-1535

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
9103
LA
101Y00000X
Counselor
PLC9103
LA
101YP2500X
Professional Counselor
Primary
9103
LA
171M00000X
Case Manager/Care Coordinator

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1306217062
MENTAL HEALTH
LA
Enumeration date
12/05/2016
Last updated
10/30/2024
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