Individual
KENYATTA LANETTE DOLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
8456 CROSS POINT DR, OLIVE BRANCH, MS 38654-4391
(662) 420-4565
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/30/2024
Last updated
01/30/2024
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