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1689931529
MICKEY FONSECA
HOUMA, LA
NPI
1689931529
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2012-04-17
Last Update Date
2012-04-17
Business Address
-- MICKEY FONSECA
420 MAGNOLIA ST
HOUMA, LA 70360-6304
Phone number: 985-879-3966
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Mailing Address
-- MICKEY FONSECA
420 MAGNOLIA ST
HOUMA, LA 70360-6304
Phone number: 985-879-3966
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