Individual
BRYAN JOEY FONSECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
805 BARROW ST STE 3, HOUMA, LA 70360-4722
(985) 857-3615
Mailing address
129 LOBLOLLY PINE DR, GRAY, LA 70359-2303
(985) 665-7404
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
210513
LA
Other
Enumeration date
02/27/2025
Last updated
02/27/2025
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