| NPI | 1790835544 |
|---|---|
| Former Legal Business Name | LOUISIANA CRITICAL INCIDENT STRESS MANAGEMENT |
| Entity Type | Organization |
| Authorized Contact | J. DURELL TUBERVILLE Owner 318-686-0012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA MFT482) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2014-10-20 |