Individual
KENNEDY BOXIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18063 IRA BABIN RD, PRAIRIEVILLE, LA 70769-3399
(225) 572-1486
Mailing address
18063 IRA BABIN RD, PRAIRIEVILLE, LA 70769-3399
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
012323909
LA
Other
Enumeration date
01/11/2022
Last updated
01/11/2022
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