Provider Demographics
NPI:1902110661
Name:LANGLOIS, JESSICA H
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:H
Last Name:LANGLOIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8434 POINTE COUPEE RD
Mailing Address - Street 2:
Mailing Address - City:MORGANZA
Mailing Address - State:LA
Mailing Address - Zip Code:70759-3320
Mailing Address - Country:US
Mailing Address - Phone:225-638-3767
Mailing Address - Fax:225-638-4058
Practice Address - Street 1:8434 POINTE COUPEE RD
Practice Address - Street 2:
Practice Address - City:MORGANZA
Practice Address - State:LA
Practice Address - Zip Code:70759-3320
Practice Address - Country:US
Practice Address - Phone:225-638-3767
Practice Address - Fax:225-638-4058
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA76251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical