# WELLNESS CLINIC PSYCHIATRY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245687383
- **Authorized official:** HALIE L ORY (MPAS, PA-C)
- **Authorized official phone:** (337) 616-0225

## Contact information

- **Practice address:** 1615 JOHNSON ST, JENNINGS, LA 70546
- **Practice address phone:** (337) 616-0225
- **Mailing address:** P O BOX 636, JENNINGS, LA 70546
- **Mailing address phone:** (337) 616-0225

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 300215 | LA | Yes |

## Other

- **Enumeration date:** 05/18/2016
- **Last updated:** 05/18/2016