Provider Demographics
NPI:1174907919
Name:THE MOBILE ASSESSMENT TEAM
Entity type:Organization
Organization Name:THE MOBILE ASSESSMENT TEAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DESHINA
Authorized Official - Middle Name:BABINEAUX
Authorized Official - Last Name:BUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-281-3816
Mailing Address - Street 1:241 1/2 LA RUE FRANCE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3103
Mailing Address - Country:US
Mailing Address - Phone:337-552-2046
Mailing Address - Fax:
Practice Address - Street 1:241 1/2 LA RUE FRANCE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3103
Practice Address - Country:US
Practice Address - Phone:337-552-2046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty