| NPI | 1215480918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAMONICA RENEE BUTLER Therapist 225-252-6839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: LA 1014733) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2016-07-28 |