Organization
PSYCHIATRY NOLA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLLEEN SHANNON HAGEMANN MD (OWNER)
(504) 952-6322
Entity
Organization
Contact information
Practice address
1426 AMELIA ST, NEW ORLEANS, LA 70115-3622
(504) 952-6322
(504) 897-4876
Mailing address
1426 AMELIA ST, NEW ORLEANS, LA 70115-3622
(504) 952-6322
(504) 897-4876
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609190636
CHILD AND ADOLESCENT PSYCHIATRY
LA
Enumeration date
01/31/2019
Last updated
01/31/2019
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