Individual
DUSTIN MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CIT
Contact information
Practice address
201 W BAYOU ST, FARMERVILLE, LA 71241-2707
(318) 368-3363
Mailing address
201 W BAYOU ST, FARMERVILLE, LA 71241-2707
(318) 368-3363
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CIT5315
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006986744
DRIVERS LICENSE
LA
Enumeration date
03/15/2022
Last updated
03/15/2022
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