Individual
MR. IVAN MYLES FERROUILLET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
127 S SOLOMON ST, NEW ORLEANS, LA 70119-5928
(504) 676-0748
Mailing address
127 S SOLOMON ST, NEW ORLEANS, LA 70119-5928
(504) 676-0748
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
000000000000000000
LA
171M00000X
Case Manager/Care Coordinator
Primary
15066
LA
Other
Enumeration date
01/06/2016
Last updated
01/03/2019
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