Organization
DECLOUET PSYCHIATRIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW ALEXANDER DECLOUET PMHNP (NURSE PRACTITIONER)
(337) 280-0441
Entity
Organization
Contact information
Practice address
100 BILLEAUD LN, LAFAYETTE, LA 70506-3108
(337) 280-0441
Mailing address
100 BILLEAUD LN, LAFAYETTE, LA 70506-3108
(337) 280-0441
Taxonomy
Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
AP08470
LA
Other
Enumeration date
10/21/2015
Last updated
06/08/2016
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