| NPI | 1447685839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD LOUIS SIBILLE Provider 337-945-1032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 5048) |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2022-09-22 |