Individual
KYNNEDI JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
758 ROYAL ST, BATON ROUGE, LA 70802-6433
(225) 529-3890
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(409) 455-4168
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/15/2023
Last updated
09/15/2023
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