| NPI | 1386959617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYELIZABETH FORMAN Member 504-780-1702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 975) |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2010-08-11 |