Individual
CANISHA BACCHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8325 KELWOOD AVE, BATON ROUGE, LA 70806-4804
(225) 239-5498
Mailing address
7580 KINGSPORT BLVD, NEW ORLEANS, LA 70128-2114
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/28/2015
Last updated
03/11/2021
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