Provider Demographics
NPI:1437549102
Name:MOGABGAB, TUYL F (LCSW)
Entity type:Individual
Prefix:
First Name:TUYL
Middle Name:F
Last Name:MOGABGAB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 W ESPLANADE AVE N
Mailing Address - Street 2:UNIT A
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-2601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3400 W ESPLANADE AVE N
Practice Address - Street 2:UNIT A
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-2601
Practice Address - Country:US
Practice Address - Phone:504-309-6267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA113051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical