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Organization

TIMBERLAKE PSYCHOLOGY GROUP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAROL ANN SELF PHD (PSYCHOLOGIST)
(985) 624-5466
Entity
Organization

Contact information

Practice address
301 GIROD STREET, MANDEVILLE, LA 70448
(985) 624-5466
(985) 624-9839
Mailing address
PO BOX 975, MANDEVILLE, LA 70470-0975
(985) 624-5466
(985) 624-9839

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
620
LA

Other

Enumeration date
01/09/2007
Last updated
08/22/2020
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