Healthcare Provider Details

I. General information

NPI: 1265336168
Provider Name (Legal Business Name): RICHLYN ALYCE TEACHOUT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1363 LOUISVILLE AVE
MONROE LA
71201-6021
US

IV. Provider business mailing address

114 CARRIAGE HILLS DR
WEST MONROE LA
71291-3802
US

V. Phone/Fax

Practice location:
  • Phone: 318-301-6001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberL-1153
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: