| NPI | 1750575684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBERT H. VAN BUREN Owner/Psychologist 318-323-6162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: LA 30) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2007-09-04 |