Individual
MR. MICHAEL JACOB EFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
303 VETERAN BLVD, DENHAM SPRINGS, LA 70726
(225) 369-2363
Mailing address
401 S COLLEGE ST, DENHAM SPRINGS, LA 70726-3327
(225) 361-3017
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011088525
011088525
LA
Enumeration date
04/10/2019
Last updated
04/10/2019
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