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Individual

MR. GEORGE MADDOCKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC, NBCC

Contact information

Practice address
8752 QUARTERS LAKE RD, BLDG 9, BATON ROUGE, LA 70809-7306
(225) 922-9122
(225) 922-9125
Mailing address
8752 QUARTERS LAKE RD, BLDG 9, BATON ROUGE, LA 70809-7306
(225) 922-9122
(225) 922-9125

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1816
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13971463
CAQH
LA
Enumeration date
07/02/2015
Last updated
03/02/2017
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