Individual
JENNIFER WELLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBA, BCBA
Contact information
Practice address
132 DEMANADE BLVD, LAFAYETTE, LA 70503-2508
(337) 534-8679
(337) 534-0027
Mailing address
132 DEMANADE BLVD, LAFAYETTE, LA 70503-2508
(337) 534-8679
(337) 534-0027
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-249
LA
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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