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Individual

JENNA M QUERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
84 SW EVANGELINE TRWY, SUITE 174, LAFAYETTE, LA 70501-8240
(540) 383-7133
Mailing address
35 WALPOLE ST STE 207, STAFFORD, VA 22554-6546

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
R-6400
LA

Other

Enumeration date
02/11/2020
Last updated
01/19/2021
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