MEDICARE: MS. JANE LABRECHE HEBERT LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	2356	LA

General Provider Information

NPI Number	:	1902909146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANE LABRECHE HEBERT LCSW

Provider Business Mailing Address
First Line	:	2901 RIDGELAKE DR
Second Line	:	SUITE 102
City	:	METAIRIE
State	:	LA
Zip	:	70002-4946
Country	:	US
Telephone Number	:	504-835-9387
Fax Number	:	504-837-6055

Provider Business Practice Location Address
First Line	:	2901 RIDGELAKE
Second Line	:	SUITE 102
City	:	METAIRIE
State	:	LA
Zip	:	70002-4946
Country	:	US
Telephone Number	:	504-835-9387
Fax Number	:	504-837-6055

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	07/08/2007

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