Individual
BERRY FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11616 SOUTHFORK AVE, BATON ROUGE, LA 70816-5241
(225) 291-9646
Mailing address
7300 ROUGON RD TRLR 14, PORT ALLEN, LA 70767-5284
(409) 828-7848
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
013303374
LA
Other
Enumeration date
09/04/2025
Last updated
09/04/2025
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