Doctor Name: | KAY FRAZIER BUSH |
NPI Number: | 1073794004 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.P.C. |
License Number: | 2939 |
Business Practice Address: | 415 N Cutting Ave Jennings, LA - 705465963 |
Business Phone Number: | 3378244200 |
Business Fax Number: | |
Mailing Address: | 415 N Cutting Ave, JENNINGS |
State: | LA |
Postal Code: | 705465963 |
Phone Number: | 3378244200 |
Fax Number: | |
NPI Enumeration Date: | 11/19/2007 |
NPI Last Update Date: | 01/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2939 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |