| NPI | 1639567290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY STUBBLEFIELD Owner 985-641-4934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 1297) |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2015-01-06 |