Individual
JENNIFER GAY SHIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
23515 HWY 190, MANDEVILLE, LA 70470-3850
(985) 626-6300
(985) 626-6467
Mailing address
PO BOX 3850, 23515 HWY 190, MANDEVILLE, LA 70470-3850
(985) 626-6300
(985) 626-6467
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
989
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043264251
NPI FACILITY
LA
Enumeration date
04/16/2007
Last updated
07/08/2007
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