Individual
REGAN JESSICA BENNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4201 N I 10 SERVICE RD W, METAIRIE, LA 70006-6713
(225) 407-2999
Mailing address
4201 N I 10 SERVICE RD W, METAIRIE, LA 70006-6713
(225) 407-2999
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
LA
Other
Enumeration date
05/23/2019
Last updated
05/23/2019
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