| NPI | 1356020044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN ROPER Authorized Official 318-225-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2023-07-12 |
| Last Update Date | 2023-07-12 |