Individual
MS. REBECCA BARR BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LIC CLIN SOCIAL WORK
Contact information
Practice address
901 WHITE ST, RUSTON MENTAL HEALTH CENTER, RUSTON, LA 71270
(318) 251-4150
(318) 251-4177
Mailing address
112 LAKE POWELL DR, WEST MONROE, LA 71292
(318) 396-2459
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2664
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710342
—
LA
Enumeration date
04/22/2006
Last updated
07/08/2007
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