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NPI Code Detail

MEDICARE: NOLA PLAY THERAPY, LLC

MEDICARE: NOLA PLAY THERAPY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor4425LA

General Provider Information

NPI Number : 1598082596
Entity Type Code : Organization
Provider Name (Legal Business Name) : NOLA PLAY THERAPY, LLC
Provider Business Mailing Address
First Line : PO BOX 6744
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70174-6744
Country : US
Telephone Number : 504-309-7844
Fax Number : 504-309-7845
Provider Business Practice Location Address
First Line : 122 SIERRA CT
Second Line :
City : METAIRIE
State : LA
Zip : 70001-5326
Country : US
Telephone Number : 337-380-4339
Fax Number : 504-309-7845
Authorized Official
Title or Position : PRESIDENT
Name : ADRIANNE LOLAN
Credential : LPC
Telephone Number : 337-380-4339
Provider Enumeration Date : 04/29/2010
Last Update Date : 04/29/2010

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Directions to “NOLA PLAY THERAPY, LLC ” Practice Location

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