Individual
DYNESTY GILLIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
311 CHURCH ST, NATCHITOCHES, LA 71457-4612
(318) 451-6011
Mailing address
1410 DEHART DR, NEW IBERIA, LA 70560-6902
(337) 806-5243
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/25/2025
Last updated
04/25/2025
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