Individual
MICTISSA CHAPMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3084 WESTFORK DR STE C, BATON ROUGE, LA 70816-2254
(225) 296-6083
Mailing address
4628 BLUERIBBON DR, BATON ROUGE, LA 70814-8035
(225) 636-3270
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/27/2017
Last updated
08/05/2024
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