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General NPI Number Information
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NPI Number | 1366974388
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Entity Type | Individual
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Provider Name | LOUISE CASEY
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Gender | Female
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | 33761 DIANA DR
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City | DANA POINT
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State | CA
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Zip | 92629-2308
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Country | US
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Telephone | 949-400-4048
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Fax | 949-209-5824
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Provider Business Mailing Address
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Address Line | 33761 DIANA DR
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City | DANA POINT
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State | CA
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Zip | 92629-2308
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Country | US
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Telephone | 949-400-4048
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Fax | 949-209-5824
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-17-335876
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License Number State | CA
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