Individual
NYLA BLAIR WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17542 FIVE OAKS DR, BATON ROUGE, LA 70810-6553
(225) 290-2670
Mailing address
17542 FIVE OAKS DR, BATON ROUGE, LA 70810-6553
(225) 290-2670
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
011470342
LA
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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