Organization
WELLNESS CLINIC PSYCHIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HALIE L ORY (MPAS, PA-C)
(337) 616-0225
Entity
Organization
Contact information
Practice address
1615 JOHNSON ST, JENNINGS, LA 70546
(337) 616-0225
Mailing address
P O BOX 636, JENNINGS, LA 70546
(337) 616-0225
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
300215
LA
Other
Enumeration date
05/18/2016
Last updated
05/18/2016
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