Individual
BRANDI WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3084 WESTFORK DR STE C, BATON ROUGE, LA 70816-2254
(225) 929-6355
(225) 296-6082
Mailing address
9403 MANSFIELD RD, SHREVEPORT, LA 71118-3815
(318) 861-8938
(318) 862-3554
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/19/2016
Last updated
11/08/2023
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