Healthcare Provider Details

I. General information

NPI: 1861838757
Provider Name (Legal Business Name): BIANCHINI-OGDEN & EPKER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2013
Last Update Date: 05/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450A OLD SHELL RD
MOBILE AL
36607-3020
US

IV. Provider business mailing address

2901 N I 10 SERVICE RD E SUITE 300
METAIRIE LA
70002-6137
US

V. Phone/Fax

Practice location:
  • Phone: 504-780-1702
  • Fax: 504-780-1705
Mailing address:
  • Phone: 504-780-1702
  • Fax: 504-780-1705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1107
License Number StateAL

VIII. Authorized Official

Name: JASON EPKER
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 504-780-1702