Organization · NPI-2

Dyer Psychiatric Services

Nurse Practitioner, Psych/Mental Health · Lake Charles, LA

NPI number1689318206
StatusActive
Last updated in NPPESJan 25, 2024

Details

NPI
1689318206
Entity type
Organization (NPI-2)
Legal business name
Dyer Psychiatric Services
Organization subpart
No
Enumeration date
Apr 21, 2022
Certification date
Jan 25, 2024
Last updated
Jan 25, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0808X Nurse Practitioner, Psych/Mental Health––Yes
163WP0809X Registered Nurse, Psych/Mental Health, Adult––

Practice location

748 Bayou Pines East Dr Ste C
Lake Charles, LA 70601-7596

Phone 337-422-6731

Mailing address

748 Bayou Pines East Dr Ste C
Lake Charles, LA 70601-7596

Phone 337-422-6731

Authorized official

Kala Duhon
Credentialing Manager
3374226731

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