Provider Demographics
NPI:1598975054
Name:GUILLORY, PATRICIA A (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:A
Last Name:GUILLORY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 ATHANIA PKWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-5981
Mailing Address - Country:US
Mailing Address - Phone:504-638-8952
Mailing Address - Fax:504-305-6345
Practice Address - Street 1:2820 ATHANIA PKWY
Practice Address - Street 2:SUITE 2
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-5981
Practice Address - Country:US
Practice Address - Phone:504-638-8952
Practice Address - Fax:504-305-6345
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA21311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical