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1720808926
KALEB D BANKSTON
PRAIRIEVILLE, LA
NPI
1720808926
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: LA 012333472)
Enumeration Date
2024-10-12
Last Update Date
2024-10-12
Business Address
Mr. KALEB D BANKSTON
17534 OLD JEFFERSON HWY
PRAIRIEVILLE, LA 70769-3978
Phone number: 985-500-3130
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Mailing Address
Mr. KALEB D BANKSTON
996 ROYAL MARCO WAY
MARCO ISLAND, FL 34145-1829
Phone number:
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