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Individual

EYAN WESS CEA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1409 KIRKMAN ST, LAKE CHARLES, LA 70601-5344
(337) 419-3583
Mailing address
1409 KIRKMAN ST, LAKE CHARLES, LA 70601-5344
(337) 419-3583

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
06/01/2017
Last updated
06/01/2017
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