| NPI | 1578610275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE L FULLER President Office Manager 318-934-1919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 1161021) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |