Individual
JAN WHITAKER-GATEWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2455 WOODDALE BLVD, BATON ROUGE, LA 70805-7569
(225) 922-3169
(225) 922-3225
Mailing address
PO BOX 18242, SHREVEPORT, LA 71138-1242
(318) 518-4996
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
5379
LA
Other
Enumeration date
02/27/2017
Last updated
04/19/2023
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