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1013363241
MICON GAINES
BAKER, LA
NPI
1013363241
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-05-06
Last Update Date
2016-05-06
Business Address
Mr. MICON GAINES
4206 N. MORVANT PL.
BAKER, LA 70714
Phone number: 225-367-5310
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Mailing Address
Mr. MICON GAINES
4206 N MORVANT PL
BAKER, LA 70714-4722
Phone number:
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