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Organization

BAMBURG CONSULTING, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JERALD WAYNE BAMBURG JR. PH.D. (EXECUTIVE DIRECTOR)
(318) 442-4498
Entity
Organization

Contact information

Practice address
106 N BEND DR, PINEVILLE, LA 71360-4677
(318) 442-4498
Mailing address
106 N BEND DR, PINEVILLE, LA 71360-4677
(318) 442-4498

Taxonomy

Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
951
LA
103TB0200X
Cognitive & Behavioral Psychologist
951
LA
103TC0700X
Clinical Psychologist
Primary
951
LA
103TC2200X
Clinical Child & Adolescent Psychologist
951
LA
103TF0200X
Forensic Psychologist
951
LA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
951
LA

Other

Enumeration date
08/28/2008
Last updated
08/28/2008
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