Individual
JENNIFER JOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2016 OAK PARK BLVD, LAKE CHARLES, LA 70601-7828
(337) 540-9737
Mailing address
2016 OAK PARK BLVD, LAKE CHARLES, LA 70601-7828
(337) 429-5248
(337) 656-2377
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-17-27755
LA
103K00000X
Behavior Analyst
Primary
L-243
LA
Other
Enumeration date
10/25/2017
Last updated
03/07/2019
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