| NPI | 1750928693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MYRICK Billing Specialist 504-833-6730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2019-12-10 |