Organization
EARLY BEHAVIORAL INTERVENTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AGRA MARTIN (OWNER)
(337) 781-4836
Entity
Organization
Contact information
Practice address
1224 N PARKERSON AVE, CROWLEY, LA 70526-3614
(337) 781-4836
Mailing address
1022 N AVENUE B, CROWLEY, LA 70526-3540
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
08/05/2016
Last updated
08/05/2016
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