Individual
CARLY DANIELLE MOUTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
207 CALYPSO LN, LAFAYETTE, LA 70508-5109
(225) 270-6454
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
008746319
LA
Other
Enumeration date
08/23/2020
Last updated
08/23/2020
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