Individual
MR. CHARLES BOURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
644 N CARROLLTON AVE, NEW ORLEANS, LA 70119-4760
(504) 383-3324
Mailing address
644 N CARROLLTON AVE, NEW ORLEANS, LA 70119-4760
(504) 383-3324
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8736
LA
Other
Enumeration date
09/12/2024
Last updated
09/12/2024
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