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General NPI Number Information
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NPI Number | 1245521418
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Entity Type | Organization
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Legal Business Name | LOUIS DESONIER, PHD PA
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Dates
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Enumeration Date | 04/22/2011
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Last Update Date | 05/25/2011
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Provider Practice Location Address
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Address Line | 1717 NORTH 'E' ST. SUITE 303
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City | PENSACOLA
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State | FL
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Zip | 32501-6339
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Country | US
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Telephone | 850-444-7054
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Fax | 850-434-8210
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Provider Business Mailing Address
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Address Line | 1717 NORTH 'E' ST SUITE 303
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City | PENSACOLA
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State | FL
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Zip | 32501-6339
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Country | US
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Telephone | 850-444-7054
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Fax | 850-434-8210
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Authorized Official
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Title or Position | OWNER OF PA
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Name | DR. LOUIS GONZARA DESONIER
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Credential | PHD
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Telephone | 850-444-7054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY3062
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License Number State | FL
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