Individual
MS. VIRGINIA ALICE BALDASSARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
814 W 21ST AVE, COVINGTON, LA 70433-7405
(985) 200-3382
Mailing address
814 W 21ST AVE, COVINGTON, LA 70433-7405
(985) 200-3382
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5693
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5693
LICENSURE
LA
Enumeration date
10/27/2014
Last updated
07/14/2023
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