Individual
JACOB DAVID BREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6338 MORGAN RD, GREENWELL SPRINGS, LA 70739-4347
(225) 405-2833
Mailing address
6338 MORGAN RD, GREENWELL SPRINGS, LA 70739-4347
(225) 405-2833
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/15/2019
Last updated
08/15/2019
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