Organization
JADED LOTUS ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOJUAN FULLWILEY BCBA (OWNER)
(901) 498-0108
Entity
Organization
Contact information
Practice address
5115 COVINGTON WAY STE 5, MEMPHIS, TN 38134-5619
(901) 498-0108
(901) 910-3399
Mailing address
5115 COVINGTON WAY STE 5, MEMPHIS, TN 38134-5619
(901) 498-0108
(901) 910-3399
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/27/2023
Last updated
02/27/2023
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