Most Relevant Information
Provider Data
| NPI Number: | 1003264649 |
| Provider Name: | TA'ERICA MANUEL |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/24/2016 |
| Last Updated: | 06/14/2018 |
Provider Practice Location
1113 LAVENDER DR
WINNSBORO
LA
71295
Practice Location Phone/Fax
| Phone: | 3184397833 |
| Fax: |
Provider Mailing Location
1704 SCOTT ST APT B
WINNSBORO
LA
712953636
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |