Healthcare Provider Details

I. General information

NPI: 1134985856
Provider Name (Legal Business Name): CLAIRE M PREJEAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2024
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 FENETRE RD
SCOTT LA
70583-5508
US

IV. Provider business mailing address

607 FENETRE RD
SCOTT LA
70583-5508
US

V. Phone/Fax

Practice location:
  • Phone: 337-257-7754
  • Fax:
Mailing address:
  • Phone: 337-205-2377
  • Fax: 833-206-5890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberL-817
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: