| NPI | 1922363548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEL LYNN REILLY Therapist 225-571-5996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 9367) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2012-07-10 |