Organization Name: | BAMBURG CONSULTING, INC. |
NPI Number: | 1083862353 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JERALD WAYNE BAMBURG (EXECUTIVE DIRECTOR) |
Mailing Address: | 106 N Bend Dr Pineville |
State: | LA US |
Postal Code: | 713604677 |
Phone Number: | 3184424498 |
Fax Number: | |
NPI Enumeration Date: | 08/28/2008 |
NPI Last Update Date: | 08/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TA0700X |
License Number: | 951 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Adult Development & Aging |
Taxonomy Definition: |