Individual
MRS. GWENTH GEORGETOWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5589 S AFTON PKWY, BATON ROUGE, LA 70806
(225) 281-7157
Mailing address
5589 S AFTON PKWY, BATON ROUGE, LA 70806-3543
(225) 281-7157
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/17/2017
Last updated
07/31/2018
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