Organization
BIG EASY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKOLE L DOMINIQUE-MAIKELL MS LMFT (OWNER/THERAPIST)
(504) 233-2295
Entity
Organization
Contact information
Practice address
1799 STUMPF BLVD, BUILDING 2, SUITE 5, TERRYTOWN, LA 70056
(504) 233-2295
(504) 910-0651
Mailing address
1799 STUMPF BLVD, BUILDING 2, SUITE 5, TERRYTOWN, LA 70056
(504) 233-2295
(504) 910-0651
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/21/2022
Last updated
05/24/2022
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