Organization
COGNITIVE DEVELOPMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADRIAN FISHER (DIRECTOR)
(318) 387-1304
Entity
Organization
Contact information
Practice address
1816 ROSELAWN AVE, MONROE, LA 71201-5434
(318) 387-1304
(318) 387-1306
Mailing address
PO BOX 7563, MONROE, LA 71211-7563
(318) 387-1304
(318) 387-1306
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
ADC 11719
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1626139
—
LA
Enumeration date
09/20/2006
Last updated
08/22/2020
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