Individual
AMY E CAVANAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD LLC
Contact information
Practice address
3312 KALISTE SALOOM RD BLDG 1, LAFAYETTE, LA 70508-7449
(337) 534-0727
(337) 534-0737
Mailing address
3312 KALISTE SALOOM RD BLDG 1, LAFAYETTE, LA 70508-7449
(337) 534-0727
(337) 534-0737
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
998
LA
103TB0200X
Cognitive & Behavioral Psychologist
998
LA
103TC0700X
Clinical Psychologist
Primary
998
LA
103TC1900X
Counseling Psychologist
998
LA
103TC2200X
Clinical Child & Adolescent Psychologist
998
LA
103TF0000X
Family Psychologist
998
LA
103TP2701X
Group Psychotherapy Psychologist
998
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2125541
—
LA
Enumeration date
01/18/2007
Last updated
01/31/2024
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