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General NPI Number Information
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NPI Number | 1609306117
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Entity Type | Individual
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Provider Name | MALLORIE PAIGE GALJOUR BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 06/16/2017
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Last Update Date | 12/21/2024
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Provider Practice Location Address
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Address Line | 19374 N 3RD ST
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City | COVINGTON
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State | LA
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Zip | 70433-8813
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Country | US
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Telephone | 504-444-3647
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Fax |
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Provider Business Mailing Address
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Address Line | 580 LOTUS DR N APT 7
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City | MANDEVILLE
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State | LA
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Zip | 70471-6752
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Country | US
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Telephone | 985-507-3232
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Fax |
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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 | L-922
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | LA
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