NPI 1104303775 · live from the CMS NPI Registry
Behavioral Specialists 2 LLC
Psychologist, Clinical Child & Adolescent in Winnfield, LA. National Provider Identifier 1104303775, active.
NPI record
| NPI | 1104303775 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical Child & Adolescent 103TC2200X |
| Practice location | 2001 W Court St, Winnfield, LA 71483 |
| Practice phone | 318-300-3560 |
| Mailing address | 925 Olive St, Shreveport, LA 71104 |
| Enumerated | July 25, 2018 |
| Last updated | July 25, 2018 |
| Authorized official | Rhonda Grady, Cfo |
| Other names | Behavioral Specialists Of Louisiana |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst | 103K00000X | — |
| Early Intervention Provider Agency | 252Y00000X | — |
| Psychologist, Clinical Child & Adolescent primary | 103TC2200X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.