Individual
JENNIE RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBA
Contact information
Practice address
2036 JACKSON ST, ALEXANDRIA, LA 71301-6439
(318) 641-0444
(318) 641-6118
Mailing address
2036 JACKSON ST, ALEXANDRIA, LA 71301-6439
(318) 641-0444
(318) 641-6118
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-194
LA
Other
Enumeration date
04/25/2017
Last updated
04/25/2017
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