Doctor Name: | MS. MARTHA ANN HERSEY |
NPI Number: | 1174706139 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | GSW |
License Number: | 8432 |
Business Practice Address: | 2106 Avenue F Bogalusa, LA - 704275027 |
Business Phone Number: | 9857326655 |
Business Fax Number: | 9857326678 |
Mailing Address: | 2106 Avenue F, BOGALUSA |
State: | LA |
Postal Code: | 704275027 |
Phone Number: | 9857326655 |
Fax Number: | 9857326678 |
NPI Enumeration Date: | 12/13/2007 |
NPI Last Update Date: | 12/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 8432 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |