| Deep Roots Behavior Support Llc | |
|
523 S Hennessey St New Orleans LA 70119-6734 | |
| (478) 731-8721 | |
| Not Available |
| Full Name | Deep Roots Behavior Support Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 523 S Hennessey St, New Orleans, Louisiana |
| Authorized Official Name and Position | Emily Wilkinson Grest (OWNER, BCBA) |
| Authorized Official Contact | 4787318721 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Deep Roots Behavior Support Llc 523 S Hennessey St New Orleans LA 70119-6734 Ph: (478) 731-8721 | Deep Roots Behavior Support Llc 523 S Hennessey St New Orleans LA 70119-6734 Ph: (478) 731-8721 |
| NPI Number | 1124891718 |
|---|---|
| Provider Enumeration Date | 11/06/2023 |
| Last Update Date | 11/06/2023 |
| Certification Date | 11/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124891718 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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