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728 Berard St Breaux Bridge LA 70517-4910 | |
| (337) 442-6823 | |
| (337) 442-8625 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 728 Berard St, Breaux Bridge, Louisiana |
| Authorized Official Name and Position | Norlet Taylor Pierre (CEO/ADMINISTRATOR) |
| Authorized Official Contact | 3374426823 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
728 Berard St Breaux Bridge LA 70517-4910 Ph: (337) 442-6823 | 728 Berard St Breaux Bridge LA 70517-4910 Ph: (337) 442-6823 |
| NPI Number | 1447860713 |
|---|---|
| Provider Enumeration Date | 08/03/2020 |
| Last Update Date | 05/01/2024 |
| Certification Date | 05/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447860713 | NPI | - | NPPES |
| 814247587 | Medicaid | LA | |
| 814247587 | Other | LA | PRIVATE INSURANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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