Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 735 | LA |
N | 103T00000X | Psychologist | 735 | LA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103G00000X | Clinical Psychologist | 735 | LA |
N | 103TC0700X | Clinical Psychologist | 735 | LA |
Y | 103TM1800X | Intellectual & Developmental Disabilities | 735 | LA |
NPI | 1053627968 |
---|---|
Provider Name | Dr. Jay A. Sevin |
First Address | New Orleans, LA 70131-3529 |
Second Address | New Orleans, LA 70131-3529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2010 |
Last Update Date | 29/02/2012 |