| NPI | 1902274467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW THRASHER Clinical Director 337-625-5766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: LA 1055) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2015-09-14 |