Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 624 | LA |
NPI | 1073039566 |
---|---|
Provider Name | Lynette Rolland |
First Address | New Orleans, LA 70124-1132 |
Second Address | New Orleans, LA 70124-1132 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2017 |
Last Update Date | 17/08/2017 |