Jaded Lotus Aba LLC
Behavior Analyst in Memphis, TN. Organization (NPI-2).
NPI number1023644366
StatusActive
Last updated in NPPESJul 11, 2023
Details
- NPI
- 1023644366
- Entity type
- Organization (NPI-2)
- Legal business name
- Jaded Lotus Aba LLC
- Organization subpart
- No
- Enumeration date
- Mar 18, 2020
- Certification date
- Jul 11, 2023
- Last updated
- Jul 11, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | – | – | Yes |
Practice location
3834 Ginkgo Ln Apt 206Memphis, TN 38125-6538
Phone 901-336-4225
Mailing address
3834 Ginkgo Ln Apt 206Memphis, TN 38125-6538
Phone 901-336-4225
Authorized official
Jojuan Fullwiley
Bcba
9014980108
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