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Individual

LUIS O CAMPOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5760 MONTICELLO DRIVE, ST GABRIEL, LA 70776
(225) 642-9676
(225) 642-9696
Mailing address
11054 E VIEUX DR, BATON ROUGE, LA 70815-5285
(225) 231-8030

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3860
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1117226
LA
Enumeration date
12/27/2006
Last updated
06/02/2008
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