| NPI | 1114339181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM LEGENDRE BOUDREAUX Contract Manager 985-493-4907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2025-06-02 |