Individual
GRACE MANUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11607 SOUTHFORK AVE, BATON ROUGE, LA 70816-5220
(888) 880-9270
Mailing address
18523 DOC OLENA DR, BATON ROUGE, LA 70817-0706
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/12/2025
Last updated
06/12/2025
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