Individual
JACOB P DEPRIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1024 E ASCENSION COMPLEX BLVD, GONZALES, LA 70737-4263
(225) 743-2445
(225) 450-1150
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 743-2445
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11750
LA
Other
Enumeration date
12/07/2023
Last updated
12/08/2023
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