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Provider Information for 1114291069


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DEBORAH R YOUNGBLOOD LCSW


Sex: Female

NPI: 1114291069
Last Updated: 2014-10-28
Certification Date:

Details

NameValue
NPI1114291069
Enumeration Date2012-02-23
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 435 HOMER RD
MINDEN, LA 71055-2933
United States

Phone: 318-371-3001 | Fax:318-371-3300
 
Primary Practice Address 435 HOMER RD
MINDEN, LA 71055-2933
United States

Phone: 318-371-3001 | Fax:318-371-3300
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 104100000X - Social Worker LA10568