Provider Demographics
NPI:1063873784
Name:RAY, VIVIAN PIAZZA (PHD)
Entity type:Individual
Prefix:
First Name:VIVIAN
Middle Name:PIAZZA
Last Name:RAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:VIVIAN
Other - Middle Name:ESTHER
Other - Last Name:PIAZZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:733 DANTE ST OFC C
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-1013
Mailing Address - Country:US
Mailing Address - Phone:504-446-6390
Mailing Address - Fax:
Practice Address - Street 1:733 DANTE ST OFC C
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-1013
Practice Address - Country:US
Practice Address - Phone:504-446-6390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-08
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1380103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical