Individual
JENNIFER BOYSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5604 ELLSWORTH RD, FORT SMITH, AR 72903-3224
(479) 926-4673
Mailing address
PO BOX 10921, FORT SMITH, AR 72917-0921
(479) 926-4673
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1-12-11455
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902152952
HOPE 4 AUTISM
AR
Enumeration date
07/21/2022
Last updated
07/21/2022
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