Individual
ALEX BOURQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
8752 QUARTERS LAKE RD., BLDG. 9, BATON ROUGE, LA 70809
(225) 922-9122
(225) 922-9125
Mailing address
8752 QUARTERS LAKE RD., BLDG. 9, BATON ROUGE, LA 70809
(225) 922-9122
(225) 922-9125
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
15404
LA
1041C0700X
Clinical Social Worker
Primary
15404
LA
Other
Enumeration date
07/16/2024
Last updated
10/23/2024
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