Provider Demographics
NPI:1982430567
Name:ALLOUCHE, SAM (PHD)
Entity type:Individual
Prefix:DR
First Name:SAM
Middle Name:
Last Name:ALLOUCHE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SAM
Other - Middle Name:
Other - Last Name:SHAW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:2738 GENERAL PERSHING ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-6226
Mailing Address - Country:US
Mailing Address - Phone:504-264-3084
Mailing Address - Fax:
Practice Address - Street 1:2738 GENERAL PERSHING ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6226
Practice Address - Country:US
Practice Address - Phone:504-264-3084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1682103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist