Individual
KELIS G'ANNA DYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17534 OLD JEFFERSON HWY STE D1, PRAIRIEVILLE, LA 70769-3978
(985) 500-3130
Mailing address
37211 MARKET PLACE DR, PRAIRIEVILLE, LA 70769-3487
(225) 456-6125
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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