Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 821 | LA |
Y | 103TC0700X | Clinical Psychologist | 821 | LA |
NPI | 1003877374 |
---|---|
Provider Name | Paula J Varnado-Sullivan |
First Address | Baton Rouge, LA 70806-6511 |
Second Address | Baton Rouge, LA 70806-6511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 08/06/2016 |