| NPI | 1184780900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA PETERSON Office Administrator 318-221-6121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 1144) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2021-11-03 |