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General NPI Number Information
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NPI Number | 1932992781
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Entity Type | Individual
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Provider Name | KENNADY GRACE ARDOIN BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 05/26/2025
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Last Update Date | 05/26/2025
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Provider Practice Location Address
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Address Line | 3600 JACKSON ST STE 123
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3096
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Country | US
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Telephone | 318-302-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 191 ROBIN HOOD RD
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City | DRY PRONG
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State | LA
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Zip | 71423-3550
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Country | US
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Telephone | 337-831-4212
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | L-973
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License Number State | LA
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