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General NPI Number Information
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NPI Number | 1659677391
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Entity Type | Organization
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Legal Business Name | ROBELOT & LEBOURGEOIS LLC
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Dates
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Enumeration Date | 01/27/2011
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Last Update Date | 02/04/2011
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Provider Practice Location Address
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Address Line | 1056 E WORTHY ST SUITE E
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City | GONZALES
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State | LA
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Zip | 70737-4369
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Country | US
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Telephone | 225-603-3135
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Fax |
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Provider Business Mailing Address
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Address Line | 1056 E WORTHY ST SUITE E
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City | GONZALES
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State | LA
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Zip | 70737-4369
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Country | US
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Telephone | 225-603-3135
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MR. ALFRED LOUIS ROBELOT JR.
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Credential | LCSW
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Telephone | 225-603-3135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 3422
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License Number State | LA
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