| NPI | 1194129445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRANT JACKSON BUTTERBAUGH Manager 504-309-9855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: LA 681) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: LA 681) |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2014-12-04 |