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1982201059
JAQUENNA LASHAY SMITH
MACON, GA
NPI
1982201059
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: GA RBT-19-108626)
Enumeration Date
2020-10-02
Last Update Date
2020-10-02
Business Address
JAQUENNA LASHAY SMITH RBT
4931 RIVERSIDE DR STE 400A
MACON, GA 31210-1195
Phone number: 478-219-7626
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Mailing Address
JAQUENNA LASHAY SMITH RBT
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS, IN 46268-6135
Phone number: 855-324-0885
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