Kennedy Andrus

Individual provider Active NPI Behavior Technician · Youngsville, LA

NPI 1750121406 · NPPES record last updated May 30, 2024

Key facts

NPI
1750121406
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
209 Centre Sarcelle Blvd Ste 201
Youngsville, LA 70592-6755
Phone
(337) 967-6645
NPI assigned
May 30, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

209 Centre Sarcelle Blvd Ste 201
Youngsville, LA 70592-6755

Mailing address

209 Centre Sarcelle Blvd Ste 201
Youngsville, LA 70592-6755
Phone (337) 967-6645

Other providers in Youngsville, LA

All providers in Youngsville, LA · Behavior Technician in Louisiana

Sources for this page

Verify at the official NPI Registry.