| Doctor Name: | MS. ESSIE B MACK |
| NPI Number: | 1124224142 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.T. |
| License Number: | CLP.G00606-GEN |
| Business Practice Address: | 1567 S Range Ave Denham Springs, LA - 707265201 |
| Business Phone Number: | 2256653500 |
| Business Fax Number: | 2256653518 |
| Mailing Address: | 1567 S Range Ave, DENHAM SPRINGS |
| State: | LA |
| Postal Code: | 707265201 |
| Phone Number: | 2256653500 |
| Fax Number: | 2256653518 |
| NPI Enumeration Date: | 06/26/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246QM0706X |
| License Number: | CLP.G00606-GEN |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Spec/Tech, Pathology |
| Taxonomy Specialization: | Medical Technologist |
| Taxonomy Definition: | |