| NPI | 1760864276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE LYNN GUNNER Member 337-519-6126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: GA Certificate) |
| Enumeration Date | 2015-06-20 |
| Last Update Date | 2015-06-20 |