Bourgoyne, Debra Brown

Bourgoyne, Debra Brown is an individual health care provider with primary practice located at 535 W Roosevelt St , Baton Rouge LA 70802-7844. She recently has only one registered license in Other Service Providers / Contractor, which is considered as her primary health care specialty. Bourgoyne, Debra Brown can be contacted via phone (225) 343-4232.

Contact Information

Primary practice address
535 W Roosevelt St Baton Rouge LA 70802-7844
Fax: (225) 343-4233
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X Z10549 Louisiana

Profile Details

NPI number 1144426990
LBN Legal business name Bourgoyne, Debra Brown
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2007
Last updated Jul 26th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144426990 NPPES
Louisiana MEDICAID 1302546

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