Basic Information
| Provider Information | |||||||||
| NPI: | 1306187083 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ESCANDELL & ASSOCIATES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6016 NAVAHO TRL | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713012735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184511115 | ||||||||
| FaxNumber: | 3184489088 | ||||||||
| Practice Location | |||||||||
| Address1: | 6016 NAVAHO TRL | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713012735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184511115 | ||||||||
| FaxNumber: | 3184489088 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2013 | ||||||||
| LastUpdateDate: | 03/06/2013 | ||||||||
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| AuthorizedOfficialLastName: | ESCANDELL | ||||||||
| AuthorizedOfficialFirstName: | VINCENT | ||||||||
| AuthorizedOfficialMiddleName: | ANTHONY | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3184511115 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PHD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 784 | LA | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.