Individual
MR. JONATHON BRADLEY MOREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
2519 RYAN ST, LAKE CHARLES, LA 70601-7323
(337) 491-0800
Mailing address
5200 NELSON RD APT 1311, LAKE CHARLES, LA 70605-0818
(337) 532-4831
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-38169
LA
Other
Enumeration date
10/01/2019
Last updated
10/01/2019
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