Individual
GRETCHEN G BANKSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4919 JAMESTOWN AVE STE 101, BATON ROUGE, LA 70808-3228
(225) 924-6621
(225) 924-6627
Mailing address
4919 JAMESTOWN AVE STE 101, BATON ROUGE, LA 70808-3228
(225) 924-6621
(225) 924-6627
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2661
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1917389
—
LA
Enumeration date
01/18/2007
Last updated
02/15/2011
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