Provider Demographics
NPI:1104296953
Name:JABOUR, NED MICHAEL SR (PHD PSY)
Entity type:Individual
Prefix:DR
First Name:NED
Middle Name:MICHAEL
Last Name:JABOUR
Suffix:SR
Gender:M
Credentials:PHD PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 HUDSON LANE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201
Mailing Address - Country:US
Mailing Address - Phone:318-387-7722
Mailing Address - Fax:318-325-0872
Practice Address - Street 1:217 HUDSON LANE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201
Practice Address - Country:US
Practice Address - Phone:318-387-7722
Practice Address - Fax:318-325-0872
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA68101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health