Individual
KYLE GREVIOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4315 BLUEBONNET BLVD STE B, BATON ROUGE, LA 70809-9661
(225) 223-6968
(225) 442-1396
Mailing address
4315 BLUEBONNET BLVD STE B, BATON ROUGE, LA 70809-9661
(225) 223-6968
(225) 442-1396
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/09/2018
Last updated
03/09/2018
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