Individual
MYDIA DELISE GIVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 SOUTH BROAD STREET, SUITE 7, NEW ORLEANS, LA 70019
(504) 309-9991
Mailing address
200 S BROAD ST STE 7, NEW ORLEANS, LA 70119-6447
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538597893
—
LA
Enumeration date
09/18/2017
Last updated
09/18/2017
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