Individual
ETHAN JURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
806 N BROAD ST, NEW ORLEANS, LA 70119-4209
(215) 913-8059
Mailing address
806 N BROAD ST, NEW ORLEANS, LA 70119-4209
(215) 913-8059
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/20/2017
Last updated
04/20/2017
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