Individual
MELISSA BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4615 GOVERNMENT ST, BUILDING 2, BATON ROUGE, LA 70806-5820
(225) 925-1906
(225) 925-1987
Mailing address
4615 GOVERNMENT ST, BUILDING 2, BATON ROUGE, LA 70806-5820
(225) 925-1906
(225) 925-1987
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7662
LA
Other
Enumeration date
12/02/2008
Last updated
10/01/2009
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