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NPI Code Detail

MEDICARE: BRANDON TRIGGS

MEDICARE: BRANDON TRIGGS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2101YM0800XMental Health CounselorLA

General Provider Information

NPI Number : 1174977565
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDON TRIGGS
Provider Business Mailing Address
First Line : 3973 CHOCTAW DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70805-6722
Country : US
Telephone Number : 225-361-0507
Fax Number :
Provider Business Practice Location Address
First Line : 3973 CHOCTAW DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70805-6722
Country : US
Telephone Number : 225-361-0507
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2016
Last Update Date : 12/24/2018

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Directions to “ BRANDON TRIGGS ” Practice Location

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