Individual
IRELYN CLAIRE HEATHCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1028 E WORTHY ST, GONZALES, LA 70737-4367
(855) 345-2273
Mailing address
2419 HEBERT DR, LA PLACE, LA 70068-6509
(504) 717-7765
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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