| NPI | 1437555042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYN HASSENBOEHLER Clinical Social Worker 225-456-0093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 3340) |
| Additional Taxonomies | 251S00000X (Licence: LA 3340) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2016-08-31 |