Individual
BETHANNIE DAWN LYNETTE MCCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1325 W CAUSEWAY APPROACH, MANDEVILLE, LA 70471-3043
(855) 345-2273
Mailing address
PO BOX 1288, PEARL RIVER, LA 70452-1288
(985) 707-2613
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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