| NPI | 1245507821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAXINE ELIZABETH CAMPBELL Owner 225-719-1988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC0700X Psychologist, Clinical (Licence: LA 773) | |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2011-11-26 |
| Last Update Date | 2022-12-12 |