Provider Demographics
NPI:1427533520
Name:STOUSE, MARGUERITE
Entity type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:
Last Name:STOUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARGOT
Other - Middle Name:
Other - Last Name:STOUSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1320 BURDETTE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-4018
Mailing Address - Country:US
Mailing Address - Phone:504-914-9007
Mailing Address - Fax:
Practice Address - Street 1:3520 GENERAL DEGAULLE DR STE 4070
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-4025
Practice Address - Country:US
Practice Address - Phone:504-363-7449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA49121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical