Healthcare Provider Details

I. General information

NPI: 1922928142
Provider Name (Legal Business Name): PATRICIA ANN IDROGO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4202 N I- 10 SERVICE RD W
METAIRIE LA
70006
US

IV. Provider business mailing address

1525 ORCHID DR
HARVEY LA
70058-2423
US

V. Phone/Fax

Practice location:
  • Phone: 877-418-2978
  • Fax:
Mailing address:
  • Phone: 504-655-0697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: