Individual
JAYLON NICHOLS-DOBOSU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4024 W 74TH ST, PRAIRIE VILLAGE, KS 66208
(855) 832-6727
Mailing address
1421 E LINCOLN ST, WICHITA, KS 67211-3540
(614) 817-5115
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-339266
NC
Other
Enumeration date
01/31/2025
Last updated
01/31/2025
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