Individual
DR. JOHN BRANDON WAITS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
206 E REYNOLDS DR STE F2, RUSTON, LA 71270-2809
(318) 224-7223
Mailing address
3816 WOODBURN ST, RUSTON, LA 71270-8520
(850) 830-2264
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC1900X
Counseling Psychologist
Primary
1488
LA
Other
Enumeration date
02/13/2012
Last updated
03/04/2021
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