Individual
MR. DAVID M. FATHEREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
114 REPRESENTATIVE ROW, LAFAYETTE, LA 70508-3878
(337) 412-6825
(337) 504-4376
Mailing address
114 REPRESENTATIVE ROW, LAFAYETTE, LA 70508-3878
(337) 412-6825
(337) 504-4376
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
220
LA
Other
Enumeration date
05/06/2010
Last updated
11/03/2015
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