Healthcare Provider Details

I. General information

NPI: 1578866778
Provider Name (Legal Business Name): DONNA AUCOIN PH.D & ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2010
Last Update Date: 12/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 AMBASSADOR CAFFERY PKWY PROVINCE BLDG 13
LAFAYETTE LA
70508-6984
US

IV. Provider business mailing address

5000 AMBASSADOR CAFFERY PKWY PROVINCE BLDG 13
LAFAYETTE LA
70508-6984
US

V. Phone/Fax

Practice location:
  • Phone: 337-237-0788
  • Fax: 337-237-0785
Mailing address:
  • Phone: 337-237-0788
  • Fax: 337-237-0785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State

VIII. Authorized Official

Name: AUCOIN DONNA
Title or Position: OWNER
Credential: PH.D, MP
Phone: 337-237-0788