Individual
MALLORY COMEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 SAINT MARY ST, THIBODAUX, LA 70301-6527
(985) 446-6833
Mailing address
1301 SAINT MARY ST, THIBODAUX, LA 70301-6527
(985) 446-6833
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-812
LA
Other
Enumeration date
12/02/2020
Last updated
01/29/2024
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