Individual
DR. DEREK SHANMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
311 JACKSON ST, THIBODAUX, LA 70301-2621
(985) 492-1941
Mailing address
311 JACKSON ST, THIBODAUX, LA 70301-2621
(985) 492-1941
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-103
LA
Other
Enumeration date
05/23/2016
Last updated
05/23/2016
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