Healthcare Provider Details

I. General information

NPI: 1306187083
Provider Name (Legal Business Name): ESCANDELL & ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2013
Last Update Date: 09/25/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6016 NAVAHO TRL
ALEXANDRIA LA
71301-2735
US

IV. Provider business mailing address

6016 NAVAHO TRL
ALEXANDRIA LA
71301-2735
US

V. Phone/Fax

Practice location:
  • Phone: 318-451-1115
  • Fax: 318-448-9088
Mailing address:
  • Phone: 318-451-1115
  • Fax: 318-448-9088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number784
License Number StateLA

VIII. Authorized Official

Name: DR. VINCENT ANTHONY ESCANDELL
Title or Position: OWNER
Credential: PHD
Phone: 318-451-1115