Organization
MICHAEL D CHAFETZ PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHY MONTGOMERY (BUSINESS MANAGER)
(336) 659-9440
Entity
Organization
Contact information
Practice address
3520 GENERAL DEGAULLE DR, STE 3044, NEW ORLEANS, LA 70114-6757
(336) 659-8536
Mailing address
3520 GENERAL DEGAULLE DR, STE 3044, NEW ORLEANS, LA 70114-6757
(336) 659-8536
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
762
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1695513
—
LA
Enumeration date
07/14/2008
Last updated
03/14/2014
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