Provider Demographics
NPI:1356414858
Name:SAWYER, XOCHITL BAEZ
Entity type:Individual
Prefix:MRS
First Name:XOCHITL
Middle Name:BAEZ
Last Name:SAWYER
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 1:910 PIERREMONT ROAD
Mailing Address - Street 2:SUITE 410
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-2056
Mailing Address - Country:US
Mailing Address - Phone:318-861-8616
Mailing Address - Fax:318-861-8617
Practice Address - Street 1:910 PIERREMONT ROAD
Practice Address - Street 2:SUITE 410
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-2056
Practice Address - Country:US
Practice Address - Phone:318-861-8616
Practice Address - Fax:318-861-8617
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2145101YP2500X
LA125106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist