Individual
KEENON JARELL LEBLANC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
603 W GLORIA SWITCH RD, LAFAYETTE, LA 70507-2315
(337) 706-5443
Mailing address
603 W GLORIA SWITCH RD, LAFAYETTE, LA 70507-2315
(337) 706-5443
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
LA
Other
Enumeration date
05/20/2019
Last updated
05/20/2019
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