Individual
MRS. ANITA BONVILLAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
121 N TERREBONNE DR, GRAY, LA 70359-6401
(985) 791-8551
Mailing address
121 N TERREBONNE DR, GRAY, LA 70359-6401
(985) 791-8551
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
5968
LA
101YP2500X
Professional Counselor
Primary
5968
LA
Other
Enumeration date
12/01/2015
Last updated
02/08/2020
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