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General NPI Number Information
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NPI Number | 1144075946
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Entity Type | Organization
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Legal Business Name | WHOLISTIC REHABILITATION COUNSELING AND BEHAVIOR MANAGEMENT LLC
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Dates
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Enumeration Date | 04/23/2024
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 4811 HOOPER RD STE 143
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City | BATON ROUGE
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State | LA
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Zip | 70811-3904
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Country | US
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Telephone | 225-572-9622
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 74675
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City | BATON ROUGE
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State | LA
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Zip | 70874-4675
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Country | US
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Telephone | 225-572-9622
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Fax |
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Authorized Official
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Title or Position | CCO
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Name | LINDA PEACE-BUIE
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Credential | LPC
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Telephone | 225-572-9622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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