Individual
ASHLEY NICHOLE BRAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
716 KINGSLEY ST, LAKE CHARLES, LA 70601-4874
(409) 254-9805
Mailing address
716 KINGSLEY ST, LAKE CHARLES, LA 70601-4874
(409) 254-9805
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/01/2024
Last updated
10/01/2024
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