NPI 1811570369 · live from the CMS NPI Registry
Jarrett Resean Blackmore
Behavior Analyst in Baker, LA. National Provider Identifier 1811570369, active.
NPI record
| NPI | 1811570369 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 4310 Burgess Dr, Baker, LA 70714 |
| Practice phone | 225-347-4088 |
| Enumerated | May 3, 2021 |
| Last updated | May 3, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | 011083246 (LA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.