| Timberlake Psychology Group Inc | |
|
301 Girod Street Mandeville LA 70448 | |
| (985) 624-5466 | |
| (985) 624-9839 |
| Full Name | Timberlake Psychology Group Inc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 301 Girod Street, Mandeville, Louisiana |
| Authorized Official Name and Position | Carol Ann Self (PSYCHOLOGIST) |
| Authorized Official Contact | 9856245466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Timberlake Psychology Group Inc Po Box 975 Mandeville LA 70470-0975 Ph: (985) 624-5466 | Timberlake Psychology Group Inc 301 Girod Street Mandeville LA 70448 Ph: (985) 624-5466 |
| NPI Number | 1215086491 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215086491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 620 (Louisiana) | Primary |
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