Individual
MADESIA NORTHERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2546 COLLEE DRIVE, BATON ROUGE, LA 70808
(225) 330-1109
Mailing address
2546 COLLEGE DR, BATON ROUGE, LA 70808-2447
(225) 330-1109
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9422
LA
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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