Most Relevant Information
Provider Data
| NPI Number: | 1003447137 |
| Provider Name: | CLISTA HUBER |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/28/2020 |
| Last Updated: | 02/05/2020 |
Provider Practice Location
118 VILLAGE ST
SLIDELL
LA
704585302
Practice Location Phone/Fax
| Phone: | 6017998107 |
| Fax: |
Provider Mailing Location
8326 KELWOOD AVE
BATON ROUGE
LA
708064803
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |