Individual
MRS. DEBRA BROWN BOURGOYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
535 W ROOSEVELT ST, BATON ROUGE, LA 70802-7844
(225) 343-4232
(225) 343-4233
Mailing address
535 W ROOSEVELT ST, BATON ROUGE, LA 70802-7844
(225) 343-4232
(225) 343-4233
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
Z10549
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1302546
—
LA
Enumeration date
06/26/2007
Last updated
07/26/2013
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