Individual
SHYRO P POULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1443 BRIGHTSIDE DR APT 1532C, BATON ROUGE, LA 70820-4819
(318) 491-2339
Mailing address
1443 BRIGHTSIDE DR APT 1532C, BATON ROUGE, LA 70820-4819
(318) 491-2339
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
LA
Other
Enumeration date
07/16/2019
Last updated
07/16/2019
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