| NPI | 1316619406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY TALBERT Credentialing Manager 337-794-1585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 207RP1001X Internal Medicine Pulmonary Disease | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2023-05-01 |