| NPI | 1639492325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORWIN BOAKE Member 504-780-1702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: LA 661) |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2010-03-09 |