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Individual

MS. BENITA GALE BAUCOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW-BACS

Contact information

Practice address
3005 METAIRIE ROAD, METAIRIE, LA 70001-5215
(504) 931-8784
(504) 407-3005
Mailing address
803 BURGUNDY ST, NEW ORLEANS, LA 70116-3061
(504) 931-8784
(504) 407-3005

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
3296
LA
1041C0700X
Clinical Social Worker
Primary
3296
LA

Other

Enumeration date
06/03/2009
Last updated
12/13/2019
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