NPI | 1902290422 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSICA CASSO DOMANGUE Owner/Therapist 985-876-2697 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 10908) |
Enumeration Date | 2015-03-23 |
Last Update Date | 2017-01-03 |