Individual
JALEN ALEXANDER ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3173 WASHINGTON AVE, BATON ROUGE, LA 70802-2178
(225) 778-7678
Mailing address
4414 MONROE AVE, BATON ROUGE, LA 70802-1448
(225) 778-7678
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/10/2021
Last updated
08/10/2021
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