Individual
MRS. JACQUELYN RENEE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, BCBA, LBA
Contact information
Practice address
400 E ROYAL LN BLDG 3, IRVING, TX 75039-3540
(855) 832-6727
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(512) 632-3263
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
4603
TX
Other
Enumeration date
12/20/2017
Last updated
12/09/2021
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