Individual
DR. JACQUELINE MIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1733 WOODDALE BLVD, BATON ROUGE, LA 70806-1508
(225) 924-2800
(225) 924-2800
Mailing address
1733 WOODDALE BLVD, BATON ROUGE, LA 70806-1508
(225) 924-2800
(225) 924-2800
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3676
LA
Other
Enumeration date
01/27/2009
Last updated
08/08/2015
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