Doctor Name: | MS. DARLENE PETERSON AUGUSTINE |
NPI Number: | 1306895230 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW |
License Number: | 2799 |
Business Practice Address: | 243 Curtiss Rd Barksdale Afb, LA - 711102425 |
Business Phone Number: | 3184566596 |
Business Fax Number: | |
Mailing Address: | 4607 Donnie Ave, BOSSIER CITY |
State: | LA |
Postal Code: | 711112611 |
Phone Number: | 3187421052 |
Fax Number: | |
NPI Enumeration Date: | 05/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 2799 |
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 |