Individual
BROOKE BAZILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3205 NEW HIGHWAY 51 STE C, LA PLACE, LA 70068-6512
(985) 652-1809
Mailing address
3205 NEW HIGHWAY 51 STE C, LA PLACE, LA 70068-6512
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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