Provider Demographics
NPI:1295606416
Name:BAYLOR, ED'NASHA BRIANNA
Entity type:Individual
Prefix:
First Name:ED'NASHA
Middle Name:BRIANNA
Last Name:BAYLOR
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 1:10510 JOOR RD STE 300A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70818-3925
Mailing Address - Country:US
Mailing Address - Phone:225-960-2403
Mailing Address - Fax:
Practice Address - Street 1:10510 JOOR RD STE 300A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70818-3925
Practice Address - Country:US
Practice Address - Phone:225-960-2403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty