Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 1079 | LA |
N | 103T00000X | Psychologist | 1079 | LA |
Y | 103TM1800X | Intellectual & Developmental Disabilities | 1079 | LA |
N | 103TS0200X | School Psychologist | 1079 | LA |
NPI | 1033573779 |
---|---|
Provider Name | Dr. Serina Anne Faciane |
First Address | New Orleans, LA 70117-8511 |
Second Address | New Orleans, LA 70117-8511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2016 |
Last Update Date | 08/04/2016 |