| Louisiana Geriatric Psychological Services, A Professional Corporation | |
|
2851 Johnston St Suite 313 Lafayette LA 70503-3243 | |
| (337) 315-0510 | |
| (866) 865-2339 |
| Full Name | Louisiana Geriatric Psychological Services, A Professional Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 2851 Johnston St, Lafayette, Louisiana |
| Authorized Official Name and Position | Glenn W Ahava (PRESIDENT) |
| Authorized Official Contact | 3373150510 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisiana Geriatric Psychological Services, A Professional Corporation 2851 Johnston St Suite 313 Lafayette LA 70503-3243 Ph: (337) 315-0510 | Louisiana Geriatric Psychological Services, A Professional Corporation 2851 Johnston St Suite 313 Lafayette LA 70503-3243 Ph: (337) 315-0510 |
| NPI Number | 1750674024 |
|---|---|
| Provider Enumeration Date | 05/19/2011 |
| Last Update Date | 05/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750674024 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1070 (Louisiana) | Primary |
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