Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 101YS0200X | School Counselor | 006659 | LA |
N | 225400000X | Rehabilitation Practitioner | ||
N | 225C00000X | Rehabilitation Counselor |
NPI | 1003170051 |
---|---|
Provider Name | Dr. Shalanda R Judge |
First Address | Baton Rouge, LA 70806-7740 |
Second Address | Baton Rouge, LA 70806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2012 |
Last Update Date | 15/10/2020 |