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NPI Code Detail

MEDICARE: BOBBBY WASHINGTON

MEDICARE:   BOBBBY  WASHINGTON
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

General Provider Information

NPI Number : 1275990665
Entity Type Code : Individual
Provider Name (Legal Business Name) : BOBBBY WASHINGTON
Provider Business Mailing Address
First Line : 2525 YOUREE DR STE 110
Second Line :
City : SHREVEPORT
State : LA
Zip : 71104-3600
Country : US
Telephone Number : 318-742-3408
Fax Number :
Provider Business Practice Location Address
First Line : 555 SAINT TAMMANY ST
Second Line : SUITE D
City : BATON ROUGE
State : LA
Zip : 70806-6064
Country : US
Telephone Number : 225-929-9738
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2016
Last Update Date : 01/15/2016

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Directions to “ BOBBBY WASHINGTON ” Practice Location

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