| NPI | 1629494810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDALL JAMES BROUSSARD Director 337-344-0186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2014-03-12 |