Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | RNLFCSVS1703 | LA |
NPI | 1205340114 |
---|---|
Provider Name | Mazien Butler |
First Address | Baton Rouge, LA 70895-4698 |
Second Address | Baton Rouge, LA 70805-7518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2017 |
Last Update Date | 17/03/2018 |