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Individual

MRS. SIDONNA BRIGHT MCDOUGAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, RPT

Contact information

Practice address
8221 SUMMA AVE STE F, BATON ROUGE, LA 70809-3451
(423) 596-0365
Mailing address
8221 SUMMA AVE STE F, BATON ROUGE, LA 70809-3451
(423) 596-0365

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
14017
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4132753
BCBS
TN
Enumeration date
07/07/2006
Last updated
04/24/2017
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