Individual
CALVIN PEP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2601 TULANE AVE STE 300, NEW ORLEANS, LA 70119-7499
(504) 570-6120
(504) 598-5712
Mailing address
2601 TULANE AVE STE 300, NEW ORLEANS, LA 70119-7499
(504) 570-6120
(504) 598-5712
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4212
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
455588957
—
LA
Enumeration date
02/27/2020
Last updated
02/27/2020
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