NPI 1023454451 · live from the CMS NPI Registry
Behavioral Developmental Services
Behavior Analyst in Monroe, LA. National Provider Identifier 1023454451, active.
NPI record
| NPI | 1023454451 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 3201 Armand St, Monroe, LA 71201 |
| Practice phone | 318-600-6640 |
| Mailing address | Po Box 1148, West Monroe, LA 71294 |
| Enumerated | May 13, 2013 |
| Last updated | March 17, 2018 |
| Authorized official | Lloyd Boudloche, Owner/Therapist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Mental Health | 101YM0800X | 4601 (LA) |
| Behavior Analyst primary | 103K00000X | L-005 (LA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.