Healthcare Provider Details

I. General information

NPI: 1902354855
Provider Name (Legal Business Name): DANIENE NEAL PH.D., BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2016
Last Update Date: 04/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6555 PERKINS RD
BATON ROUGE LA
70808-4237
US

IV. Provider business mailing address

9764 MARKET WEST DR
BATON ROUGE LA
70810-3637
US

V. Phone/Fax

Practice location:
  • Phone: 225-368-2297
  • Fax:
Mailing address:
  • Phone: 225-614-4665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1268
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberL-275
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: