| NPI | 1013472364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN SHANNON HAGEMANN Owner 504-952-6322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2019-01-31 |