| NPI | 1366195091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHA CIESLAK Authorized Signee 337-232-6697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-02-02 |
| Last Update Date | 2025-02-25 |