Individual
MR. NATHANAEL JACOB ISAIAH NASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT, RLT
Contact information
Practice address
422 VFW RD, LEESVILLE, LA 71446-6302
(917) 526-2384
Mailing address
6722 COIT ST APT A, FORT JOHNSON, LA 71459-3216
(909) 782-8359
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
R-19463
LA
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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