Individual
DR. CARY NELSON MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
10517 KENTSHIRE CT, BATON ROUGE, LA 70810-2853
(225) 769-8335
(225) 769-8396
Mailing address
9229 BLUEBONNET BLVD, STE B, BATON ROUGE, LA 70810-2808
(225) 766-7470
(225) 766-7473
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
1035
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1345661
—
LA
Enumeration date
07/30/2007
Last updated
04/13/2014
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