Healthcare Provider Details

I. General information

NPI: 1285335794
Provider Name (Legal Business Name): MAGNOLIA ABA SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2023
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 ASPEN SQ STE F
DENHAM SPRINGS LA
70726-5322
US

IV. Provider business mailing address

133 ASPEN SQ STE F
DENHAM SPRINGS LA
70726-5322
US

V. Phone/Fax

Practice location:
  • Phone: 225-791-0617
  • Fax: 225-778-5439
Mailing address:
  • Phone: 225-791-0617
  • Fax: 225-778-5439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE CAYCE DOWDEN
Title or Position: BEHAVIOR ANALYST
Credential: M.S., BCBA, LBA
Phone: 225-791-0617