| NPI | 1831315704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY A WEISS Owner 318-322-8482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: LA 12286R) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2008-05-20 |