| NPI | 1881979995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAIME THIBODEAUX Counselor 225-802-3075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: LA 3863) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: LA 3863) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2011-10-20 |