Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | LA | |
Y | 225100000X | Physical Therapist |
NPI | 1265911812 |
---|---|
Provider Name | Barbara Jones |
First Address | Bogalusa, LA 70429-0113 |
Second Address | Bogalusa, LA 70427-8353 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2018 |
Last Update Date | 15/11/2018 |