Individual
JAVIER MONIQUE PENNYWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BACHELOR OF ARTS
Contact information
Practice address
805 S UNION ST, OPELOUSAS, LA 70570-6029
(337) 648-4004
Mailing address
230 STONE ST, EUNICE, LA 70535-2871
(337) 466-6965
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/24/2019
Last updated
09/24/2019
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