| NPI | 1275926230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DECLOUET Owner/CEO/Nurse Practitioner 337-322-2471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2022-01-27 |