Organization
RED RIVER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHTIN ANIO CSW (MENTALL HEALTH PROFESSIONAL)
(225) 244-3650
Entity
Organization
Contact information
Practice address
11832 NEWCASTLE AVE, BATON ROUGE, LA 70816-8997
(225) 244-3650
Mailing address
6683 SANDY CREEK LN, ZACHARY, LA 70791-2696
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
12883
LA
Other
Enumeration date
11/22/2016
Last updated
11/22/2016
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