Individual
MALETICA FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 MAIN ST STE 2218, BATON ROUGE, LA 70801-0014
(225) 733-3353
Mailing address
301 MAIN ST STE 2218, BATON ROUGE, LA 70801-0014
(225) 733-3353
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000000000
—
LA
Enumeration date
10/26/2015
Last updated
10/26/2015
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