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General NPI Number Information
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NPI Number | 1588476949
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Entity Type | Individual
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Provider Name | EMMANUEL J GUILLOT IV LMSW
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Gender | Male
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 3200 RIDGELAKE DR
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City | METAIRIE
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State | LA
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Zip | 70002-4963
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Country | US
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Telephone | 150-458-1433
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Fax |
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Provider Business Mailing Address
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Address Line | 3200 RIDGELAKE DR STE 100
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City | METAIRIE
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State | LA
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Zip | 70002-4959
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Country | US
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Telephone |
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 18354
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License Number State | LA
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