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General NPI Number Information
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NPI Number | 1609008788
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Entity Type | Organization
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Legal Business Name | G&R MENTAL HEALTH ASSOCIATES, INC.
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Dates
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Enumeration Date | 08/21/2009
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Last Update Date | 08/21/2009
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Provider Practice Location Address
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Address Line | 20346 DE CHENE DR UNIT 21
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City | WALKER
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State | LA
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Zip | 70785-7249
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Country | US
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Telephone | 318-607-4665
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Fax | 225-271-4793
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Provider Business Mailing Address
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Address Line | 20346 DE CHENE DR UNIT 21
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City | WALKER
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State | LA
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Zip | 70785-7249
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Country | US
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Telephone | 318-607-4665
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Fax | 225-271-4793
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ROSALIE E. RICHARD
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Credential | FNP,PMHNP,BC
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Telephone | 318-607-4665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP04081
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP04081
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License Number State | LA
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