Organization
JULIE S DYREK PMHNP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE DYREK PMHNP (OWNER)
(337) 274-9175
Entity
Organization
Contact information
Practice address
651 CONNIE DR, LAKE CHARLES, LA 70611-6060
(337) 274-9175
(844) 392-7926
Mailing address
651 CONNIE DR, LAKE CHARLES, LA 70611-6060
(337) 274-9175
(844) 392-7926
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
363LP0808X
PSYCHIATRIC AND MENTAL HEALTH NURSE PRACTITONER
LA
Enumeration date
11/10/2020
Last updated
12/04/2020
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