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Individual

IAN VIGNES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
608 ADEE LN, GRETNA, LA 70056-7620
(504) 481-0524
Mailing address
608 ADEE LN, GRETNA, LA 70056-7620
(504) 481-0524

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-171
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2427644
LA
Enumeration date
09/06/2016
Last updated
02/19/2017
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