Provider Information for 1770102162
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MARIA ELENA REYMUNDO LCSW
Sex: Female
NPI: 1770102162
Last Updated: 2020-04-15
Certification Date: 2020-04-15
Certification Date: 2020-04-15
Details
| Name | Value | ||||||||
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| NPI | 1770102162 | ||||||||
| Enumeration Date | 2020-04-15 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 17 CHAMALE DR SLIDELL, LA 70460-2559 United States Phone: 985-788-0522 | Fax: | ||||||||
| Primary Practice Address | 17 CHAMALE DR SLIDELL, LA 70460-2559 United States Phone: 985-788-0522 | Fax: | ||||||||
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