Individual
MANDI GAUBERT BONVILLAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SSP, NCSP, BCBA
Contact information
Practice address
1018 VERRETT STREET, HOUMA, LA 70360
(985) 873-6092
Mailing address
1018 VERRETT STREET, HOUMA, LA 70360
(985) 873-6092
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103TS0200X
School Psychologist
—
—
Other
Enumeration date
06/06/2016
Last updated
06/06/2016
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