Individual
BRENDA BAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1705 FELICIA AVE, TALLULAH, LA 71282
(318) 574-1232
(318) 574-8646
Mailing address
1700 LAKE ST, LAKE PROVIDENCE, LA 71254-5208
(318) 559-0551
(318) 559-0538
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/26/2018
Last updated
05/30/2018
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