Healthcare Provider Details

I. General information

NPI: 1649643164
Provider Name (Legal Business Name): PASSION GALBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2015
Last Update Date: 05/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 N 3RD ST
MONROE LA
71201
US

IV. Provider business mailing address

645 HIGHWAY 80 E
MONROE LA
71203-8527
US

V. Phone/Fax

Practice location:
  • Phone: 318-325-8748
  • Fax: 318-325-8749
Mailing address:
  • Phone: 318-345-7123
  • Fax: 318-345-7123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: