| NPI | 1215086491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL ANN SELF Psychologist 985-624-5466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 620) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |