| NPI | 1376175471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY A. STEPHENS Credentialing/Delegate 318-443-9339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2020-02-06 |