| NPI | 1578786745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN A ALLY President 337-235-8304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: LA 378MP) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: LA 378MP) |
| 103TC0700X Psychologist, Clinical (Licence: LA 378MP) | |
| 103TP0016X Psychologist, Prescribing (Medical) (Licence: LA 378MP) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |