| NPI | 1043975873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLYN WAGNER Owner/ President 225-263-6373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-11-06 |
| Last Update Date | 2025-09-10 |