Individual
JUSTIN MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3330 CANAL ST, NEW ORLEANS, LA 70119-6206
(504) 827-2701
Mailing address
3330 CANAL ST, NEW ORLEANS, LA 70119-6206
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/29/2017
Last updated
09/29/2017
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