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General NPI Number Information
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NPI Number | 1639990401
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Entity Type | Individual
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Provider Name | TRISTEN RENEE MORVANT MS, BCBA
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Gender | Female
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 1802 WILSON DR
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City | OPELOUSAS
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State | LA
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Zip | 70570-5722
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Country | US
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Telephone | 337-308-8711
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Fax |
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Provider Business Mailing Address
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Address Line | 111 TENNYSON DR
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City | BROUSSARD
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State | LA
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Zip | 70518-5359
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Country | US
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Telephone | 337-349-2856
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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-902
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License Number State | LA
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