| NPI | 1306713078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANDAR A BENNETT Office Manager 225-442-9209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-10-18 |
| Last Update Date | 2025-10-20 |