| NPI | 1245036540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHTON C VIDRINE Owner 225-268-1412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2025-02-19 |
| Last Update Date | 2025-02-20 |