Individual
CHANNEL BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2611 MERCEDES BLVD, NEW ORLEANS, LA 70114-6833
(504) 236-1816
Mailing address
2611 MERCEDES BLVD, NEW ORLEANS, LA 70114-6833
(504) 236-1816
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
14880
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/08/2017
Last updated
07/17/2023
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