Individual
MISS AUDRIA LYNETTE MUSGROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, BC-TMH
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
5204
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13859446
CAQH
LA
05
—
3618532
—
LA
Enumeration date
12/07/2015
Last updated
04/07/2023
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