| NPI | 1831220706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENIQUE ANTHONY Accountant Supervisor 2 318-484-6803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 103T00000X Psychologist |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2024-05-13 |