| NPI | 1750805149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNATHAN PAUL AUGUSTINE Pmhnp 318-264-9208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2017-07-28 |
| Last Update Date | 2017-07-28 |