Individual
JORDYN MAKENZIE LUSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13185 OLD NASHVILLE HWY, SMYRNA, TN 37167-6309
(615) 560-6622
Mailing address
507 GREYSTONE PL, SMYRNA, TN 37167-8200
(615) 715-8046
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
24-351109
TN
Other
Enumeration date
09/25/2025
Last updated
09/25/2025
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