Individual
DAMIEN ANTHONY MOSES X
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA PSYCHOLOGY
Contact information
Practice address
2540 SEVERN AVE STE 100, METAIRIE, LA 70002
(504) 454-3740
(504) 454-3738
Mailing address
2540 SEVERN AVE STE 100, METAIRIE, LA 70002-5941
(504) 454-3740
(504) 454-3738
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YM0800X
—
LA
Enumeration date
04/11/2018
Last updated
07/02/2018
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