Organization Name: | NEUROPSYCHOLOGY SERVICES OF LOUISIANA, LLC |
NPI Number: | 1073869954 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TIFFANY JENNINGS (OWNER/NEUROPSYCHOLOGIST) |
Mailing Address: | 1754 Texas St Natchitoches |
State: | LA US |
Postal Code: | 714573429 |
Phone Number: | 8669448604 |
Fax Number: | 8883309069 |
NPI Enumeration Date: | 07/30/2012 |
NPI Last Update Date: | 09/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 1148 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |