Individual
JYWANA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
733 DANTE ST, NEW ORLEANS, LA 70118-1013
(504) 517-1711
Mailing address
2408 HOUMA BLVD APT 219, METAIRIE, LA 70001-1327
(337) 532-3282
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
011914055
LA
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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