Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | LA |
NPI | 1003423450 |
---|---|
Provider Name | Paris Jewel Jacques |
First Address | Woodland Hills, CA 91367-7807 |
Second Address | New Orleans, LA 70114-6861 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2020 |
Last Update Date | 29/09/2020 |