Healthcare Provider Details

I. General information

NPI: 1851423974
Provider Name (Legal Business Name): BRIDGET MARIE CAMERON M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 10/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

843 MILLING AVE
LULING LA
70070-4442
US

IV. Provider business mailing address

843 MILLING AVE
LULING LA
70070-4442
US

V. Phone/Fax

Practice location:
  • Phone: 985-785-5852
  • Fax: 985-785-5811
Mailing address:
  • Phone: 985-785-5852
  • Fax: 985-785-5811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number20806
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: