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General NPI Number Information
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NPI Number | 1730842469
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Entity Type | Organization
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Legal Business Name | AURORA BEHAVIOR ANALYSIS, LLC
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Dates
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Enumeration Date | 10/19/2021
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Last Update Date | 10/19/2021
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Provider Practice Location Address
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Address Line | 1500 N 19TH ST
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City | MONROE
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State | LA
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Zip | 71201-4942
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Country | US
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Telephone | 985-860-2561
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 N 19TH ST
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City | MONROE
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State | LA
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Zip | 71201-4942
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Country | US
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Telephone | 985-860-2561
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATIE L BOUDLOCHE
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Credential | M.ED., BCBA, LBA
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Telephone | 985-860-2561
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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 |
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License Number State |
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