| NPI | 1790537579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISABELLE M DUBOIS Sole Member / Provider 337-523-6482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2024-04-04 |
| Last Update Date | 2024-04-04 |