Individual
JAZMYNE KAYE MYRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
105 ROLLA ST, FORT LEONARD WOOD, MO 65473-8001
(816) 469-5162
Mailing address
105 ROLLA ST, FORT LEONARD WOOD, MO 65473-8001
(218) 640-9096
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/09/2021
Last updated
12/09/2021
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