Healthcare Provider Details

I. General information

NPI: 1164621785
Provider Name (Legal Business Name): BIANCHINI-STROTHER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 07/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 KALISTE SALOOM RD SUITE #103
LAFAYETTE LA
70508-4230
US

IV. Provider business mailing address

3939 HOUMA BLVD SUITE #223
METAIRIE LA
70006-2931
US

V. Phone/Fax

Practice location:
  • Phone: 337-235-5676
  • Fax: 337-235-5642
Mailing address:
  • Phone: 504-780-1702
  • Fax: 504-780-1705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number1017
License Number StateLA

VIII. Authorized Official

Name: DARREN STROTHER
Title or Position: PARTNER
Credential: PH.D.
Phone: 504-780-1702