Individual
MARK ANTHONY AUGUSTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
645 RICHELIEU PKWY, MARKSVILLE, LA 71351-2756
(318) 308-0970
Mailing address
645 RICHELIEU PKWY, MARKSVILLE, LA 71351-2756
(318) 308-0970
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
800727633
LA
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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