OrganizationActive
Dnp-Outpatient
NPI 1235366204 · Neurodevelopmental Disabilities Physician · Mandeville, LA
Provider details
- NPI number
- 1235366204
- Entity type
- Organization
- Primary specialty
- Neurodevelopmental Disabilities PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Southeast Louisiana State Hospital
- Authorized official
- Patricia Gonzales, C.e.o.
Practice location
23515 Hwy 190
Mandeville, LA 70448
Phone: (985) 626-6300
Fax: (985) 626-6557
Mailing address
Po Box 3850
Mandeville, LA 70470-3850
Registry dates
- Enumerated
- 2009-06-17
- Last updated
- 2009-06-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.