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General NPI Number Information
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NPI Number | 1013759448
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Entity Type | Organization
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Legal Business Name | RELEAF BEHAVIORAL HEALTH AND WELLNESS CLINIC
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 4303 PLANK RD
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City | BATON ROUGE
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State | LA
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Zip | 70805-4134
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Country | US
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Telephone | 225-384-6124
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Fax |
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Provider Business Mailing Address
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Address Line | 4303 PLANK RD
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City | BATON ROUGE
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State | LA
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Zip | 70805-4134
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DAFFANEY WEBSTER
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Credential | APRN PMHNP
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Telephone | 225-384-6124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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