Individual
KYLE HANNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
326 BRETT DR, GRETNA, LA 70056-7214
(504) 309-5867
Mailing address
326 BRETT DR, GRETNA, LA 70056-7214
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
010133001
LA
Other
Enumeration date
05/18/2013
Last updated
05/18/2013
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