Individual
GREGGORY YOUNGBLOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
10508 N GLENSTONE PL, BATON ROUGE, LA 70810-2838
(225) 349-8696
(225) 349-8698
Mailing address
PO BOX 383, GROSSE TETE, LA 70740-0383
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LAC5086
LA
Other
Enumeration date
04/02/2019
Last updated
11/13/2020
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