Individual
MARY JAN GREMILLION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1900 S ACADIAN THRUWAY, BATON ROUGE, LA 70808-1665
(225) 336-8708
(225) 336-8703
Mailing address
5151 EVERETT LN, # A, BATON ROUGE, LA 70809-3693
(225) 505-5745
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6601
LA
Other
Enumeration date
08/02/2010
Last updated
08/02/2010
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