Organization
BIANCHINI-FREY/FORMAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARYELIZABETH FORMAN PHD (MEMBER)
(504) 780-1702
Entity
Organization
Contact information
Practice address
3939 HOUMA BLVD, STE 223, METAIRIE, LA 70006-2931
(504) 780-1702
(504) 780-1705
Mailing address
3939 HOUMA BLVD, STE 223, METAIRIE, LA 70006-2931
(504) 780-1702
(504) 780-1705
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
975
LA
Other
Enumeration date
08/11/2010
Last updated
08/11/2010
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