Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | 13252 | LA |
NPI | 1003281502 |
---|---|
Provider Name | Timkka Webster |
First Address | Baton Rouge, LA 70810-1998 |
Second Address | Baton Rouge, LA 70810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2015 |
Last Update Date | 04/09/2018 |