Organization
LOUISIANA GERIATRIC PSYCHOLOGICAL SERVICES, A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN W AHAVA PH.D. (PRESIDENT)
(337) 315-0510
Entity
Organization
Contact information
Practice address
2851 JOHNSTON ST, SUITE 313, LAFAYETTE, LA 70503-3243
(337) 315-0510
(866) 865-2339
Mailing address
2851 JOHNSTON ST, SUITE 313, LAFAYETTE, LA 70503-3243
(337) 315-0510
(866) 865-2339
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1070
LA
Other
Enumeration date
05/19/2011
Last updated
05/19/2011
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