Individual
BRANDY BUSHNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN, MHS
Contact information
Practice address
1409 KIRKMAN ST, LAKE CHARLES, LA 70601-5344
(337) 419-3586
Mailing address
1409 KIRKMAN ST, LAKE CHARLES, LA 70601-5344
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
164W00000X
Licensed Practical Nurse
20102587
LA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/30/2017
Last updated
06/27/2019
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