Individual
MARY BECNEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1805 COLLEGE DR, BATON ROUGE, LA 70808-1919
(225) 923-3420
Mailing address
1805 COLLEGE DR, BATON ROUGE, LA 70808-1919
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
OTT.200858
LA
Other
Enumeration date
03/23/2016
Last updated
03/23/2016
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