Individual
KEVIN BOURGEOIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
744 DANTE ST, NEW ORLEANS, LA 70118-1014
(504) 376-5445
Mailing address
123 WALNUT ST, UNIT 701, NEW ORLEANS, LA 70118-4847
(504) 376-5445
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4093
LA
Other
Enumeration date
10/06/2006
Last updated
09/23/2008
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