Individual
DIRK E ROOTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN - PMHNP-BC
Contact information
Practice address
409 N 7TH ST, SUITE 3, WEST MONROE, LA 71291-4156
(318) 322-8462
Mailing address
409 N 7TH ST, SUITE 3, WEST MONROE, LA 71291-4156
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP07063
LA
Other
Enumeration date
09/13/2012
Last updated
02/23/2013
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