Graduated: 2010
NPI: 1780989046
Practice Locations (2)
IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY
4105 KIRKMAN ST
LAKE CHARLES, LA 706074603
3374758022
IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY
145 HOSPITAL DR
OAKDALE, LA 714633034
3376393001
Source: CMS National Downloadable File, September 2026.