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General NPI Number Information
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NPI Number | 1396164281
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Entity Type | Organization
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Legal Business Name | WEST BEHAVIORAL, LLC
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Dates
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Enumeration Date | 04/08/2014
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Last Update Date | 04/08/2014
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Provider Practice Location Address
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Address Line | 514 N MORTON ST
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City | JENNINGS
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State | LA
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Zip | 70546-5450
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Country | US
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Telephone | 337-789-6836
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Fax | 866-616-5821
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Provider Business Mailing Address
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Address Line | 514 N MORTON ST
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City | JENNINGS
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State | LA
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Zip | 70546-5450
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Country | US
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Telephone | 337-789-6836
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Fax | 866-616-5821
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LINDY MICHELLE WEST
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Credential | BCBA, LBA
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Telephone | 337-789-6836
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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 | L-028
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License Number State | LA
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