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General NPI Number Information
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NPI Number | 1295836468
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Entity Type | Individual
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Provider Name | MICHELLE LONGINO LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 12/03/2016
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Provider Practice Location Address
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Address Line | 4829 PRYTANIA ST SUITE 200
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City | NEW ORLEANS
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State | LA
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Zip | 70115-4046
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Country | US
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Telephone | 504-723-0782
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Fax | 504-861-8343
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Provider Business Mailing Address
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Address Line | 7444 HURST ST SUITE L
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City | NEW ORLEANS
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State | LA
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Zip | 70118-3641
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Country | US
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Telephone | 504-723-0782
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Fax | 530-527-4245
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT113
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License Number State | LA
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