Individual
EDMUND PURCELL BRISTOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LSW, LMSW
Contact information
Practice address
2400 CANAL ST, NEW ORLEANS, LA 70119-6535
(504) 214-9603
Mailing address
4521 CROSS ST, JEFFERSON, LA 70121-1205
(504) 287-5145
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6495G
AL
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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