Individual
ROBIN G BREITHAUPT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW,DCSW
Contact information
Practice address
900 PIERREMONT RD, SUITE 214, SHREVEPORT, LA 71106-2044
(318) 629-5036
Mailing address
900 PIERREMONT RD, SUITE 214, SHREVEPORT, LA 71106-2044
(318) 629-5036
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2088
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2088
SOCIAL WORKERS LICENSE
LA
01
—
H0557
BLUE CROSS PROVIDER NUMBE
LA
Enumeration date
10/02/2006
Last updated
07/08/2007
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