Individual
RYAN ALFRED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1325 W CAUSEWAY APPROACH, MANDEVILLE, LA 70471-3043
(985) 272-1825
Mailing address
16 PARKWOOD DR, MANDEVILLE, LA 70471-7237
(985) 626-4553
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
LA
Other
Enumeration date
04/11/2018
Last updated
04/11/2018
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