Organization
NORTHLAKE NEUROREHAB CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFAEL FRANCISCO SALCEDO PH.D (NUEROPSYCHOLOGIST)
(985) 809-0929
Entity
Organization
Contact information
Practice address
60 LOUIS PRIMA DR, SUITE A, COVINGTON, LA 70433-5903
(985) 809-0929
(985) 809-0223
Mailing address
60 LOUIS PRIMA DR, SUITE A, COVINGTON, LA 70433-5903
(985) 809-0929
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
501
LA
225100000X
Physical Therapist
1574
LA
235Z00000X
Speech-Language Pathologist
1574
LA
Other
Enumeration date
09/09/2009
Last updated
09/09/2009
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