Individual
DESTINY JELIA COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1028 E WORTHY ST, GONZALES, LA 70737-4367
(504) 399-9851
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/22/2021
Last updated
08/22/2021
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