Individual
MARIO JAMAL BORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1615 PALFREY ST, GRETNA, LA 70053-3340
(504) 994-9601
Mailing address
1615 PALFREY ST, GRETNA, LA 70053-3340
(504) 994-9601
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/14/2017
Last updated
04/14/2017
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