| NPI | 1003561838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | USHA KRISHNAMOORTHY Billing Office Manager 337-534-0219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-02-21 |
| Last Update Date | 2022-05-18 |