Individual
MATTHEW WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
431 W LAFAYETTE ST, WINNFIELD, LA 71483-3463
(318) 648-0375
Mailing address
4919 CANAL ST, NEW ORLEANS, LA 70119-5848
(504) 483-9883
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7765
LA
171M00000X
Case Manager/Care Coordinator
PLC7765
LA
Other
Enumeration date
05/13/2019
Last updated
09/08/2021
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