| NPI | 1326312323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINO JOSEPH BERTUCCI Owner 225-938-9971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 4092) |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2012-03-09 |