Magnificent Minds Telemed
Magnificent Minds Telemed is a Child & Adolescent Psychiatry Physician in Gonzales, Louisiana. Registered with an NPI since 2022.
- In the registry since
- 2022
- Specialties on file
- 2
Practice location Address checks out
630 W Cornerview St Ste BGonzales, LA 70737-2742
Phone: (225) 647-4105
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Child & Adolescent Psychiatry Physician (primary) | Taxonomy 2084P0804X |
|---|---|
| Psychiatric/Mental Health Nurse Practitioner | Taxonomy 363LP0808X |
Record details
| NPI number | 1275255309 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Demarcus Patterson — Owner · (504) 908-0715 |
| NPI enumerated | September 15, 2022 |
| Last updated in NPPES | September 15, 2022 |
| Certification date | September 15, 2022 |
| Mailing address | Po Box 359, Gonzales, LA 70707-0359 |