Individual
MR. BRANDYN BAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
23592 BIG BRANCH DR, PONCHATOULA, LA 70454-5587
(985) 474-5099
Mailing address
23592 BIG BRANCH DR, PONCHATOULA, LA 70454-5587
(985) 474-5099
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
15444
LA
Other
Enumeration date
03/02/2023
Last updated
06/11/2026
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