Individual
JADA DONIELLE BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1250 SW RAILROAD AVE STE 130, HAMMOND, LA 70403-5013
(985) 500-3240
Mailing address
1712 WILLIAMSBURG DR, LA PLACE, LA 70068-2819
(985) 359-0545
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
011486058
LA
Other
Enumeration date
12/03/2020
Last updated
12/03/2020
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