Provider Demographics
NPI:1215365507
Name:HUFFMAN, JAMIE
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:HUFFMAN
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 1:500 RODERICK ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-2247
Mailing Address - Country:US
Mailing Address - Phone:985-380-2460
Mailing Address - Fax:985-380-2476
Practice Address - Street 1:500 RODERICK ST
Practice Address - Street 2:SUITE B
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-2247
Practice Address - Country:US
Practice Address - Phone:985-380-2460
Practice Address - Fax:985-380-2476
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4658101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional