Individual
MISS ANGELA DENISE PEGUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
320 S FRANKLIN ST, BASTROP, LA 71220-4539
(318) 283-0868
Mailing address
320 S FRANKLIN ST, BASTROP, LA 71220-4539
(318) 283-0868
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6613
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6613
—
LA
Enumeration date
01/12/2012
Last updated
01/12/2012
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