Healthcare Provider Details

I. General information

NPI: 1982305017
Provider Name (Legal Business Name): MICHELE L GAGNE MA BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2023
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19374 N 3RD ST
COVINGTON LA
70433-8813
US

IV. Provider business mailing address

19374 N 3RD ST
COVINGTON LA
70433-8813
US

V. Phone/Fax

Practice location:
  • Phone: 504-444-3647
  • Fax: 985-302-3584
Mailing address:
  • Phone: 504-444-3647
  • Fax: 985-302-3584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: