Individual
GABRIEL WAYNE SICARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7946 GOODWOOD BLVD, BATON ROUGE, LA 70806-7629
(225) 590-3313
(225) 590-3324
Mailing address
7946 GOODWOOD BLVD, BATON ROUGE, LA 70806-7629
(225) 380-9107
(225) 590-3324
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600964601
—
LA
Enumeration date
07/07/2020
Last updated
11/03/2020
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