| NPI | 1801289020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY C BAMBURG COO/Agent 318-442-4498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2018-02-14 |