Individual
MR. JUAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
8414 BLUEBONNET BLVD STE 110, BATON ROUGE, LA 70810-2840
(225) 978-7897
Mailing address
8414 BLUEBONNET BLVD STE 110, BATON ROUGE, LA 70810-2840
(225) 978-7897
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7718
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7718
LCSW
LA
Enumeration date
05/12/2008
Last updated
06/10/2008
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