Individual
KRISTI BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
855 SAINT FERDINAND ST, BATON ROUGE, LA 70802-6453
(225) 336-0000
(225) 336-0522
Mailing address
1979 BEAUMONT DR, BATON ROUGE, LA 70806-1410
(225) 928-1400
(225) 928-1656
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1823
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600747398
—
LA
Enumeration date
08/12/2016
Last updated
08/12/2016
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