Healthcare Provider Details

I. General information

NPI: 1629504022
Provider Name (Legal Business Name): ASIA CAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2017
Last Update Date: 05/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3420 KABEL DR
NEW ORLEANS LA
70131-6926
US

IV. Provider business mailing address

2500 WHITNEY PL APT 2-214
METAIRIE LA
70002-6253
US

V. Phone/Fax

Practice location:
  • Phone: 502-394-5937
  • Fax:
Mailing address:
  • Phone: 225-266-6548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: