Individual
DONOVAN MANUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 W VERMILION ST, LAFAYETTE, LA 70501-6729
(337) 231-6365
Mailing address
401 W VERMILION ST, LAFAYETTE, LA 70501-6729
(337) 231-6365
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/20/2015
Last updated
11/20/2015
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