Healthcare Provider Details

I. General information

NPI: 1740789056
Provider Name (Legal Business Name): CHELSEY GABRIELLE ODOM M.A,BCBA,LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSEY CATING M.A,BCBA,LBA

II. Dates (important events)

Enumeration Date: 02/02/2018
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 MILLERVILLE ROAD SUITE 1-A
BATAN ROUGE LA
70816
US

IV. Provider business mailing address

21600 OXNARD ST STE 11800
WOODLAND HILLS CA
91367-4976
US

V. Phone/Fax

Practice location:
  • Phone: 225-963-6006
  • Fax:
Mailing address:
  • Phone: 818-345-2345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberL-551
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberR-1525
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: