MEDICARE: EDDIE DEJEAN, JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1497607527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDDIE DEJEAN, JR.

Provider Business Mailing Address
First Line	:	4202 N. 1-10 SERVICE RD.
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70006
Country	:	US
Telephone Number	:	248-356-3400
Fax Number	:

Provider Business Practice Location Address
First Line	:	4202 N. 1-10 SERVICE RD.
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70006
Country	:	US
Telephone Number	:	248-356-3400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “ EDDIE DEJEAN, JR. ” Practice Location

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