MEDICARE: JACQUALYN LACOMBE BEHAVIOR TECH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1588385058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUALYN LACOMBE BEHAVIOR TECH

Provider Business Mailing Address
First Line	:	4210 OAK DR
Second Line	:
City	:	FORDOCHE
State	:	LA
Zip	:	70732-3208
Country	:	US
Telephone Number	:	225-588-6121
Fax Number	:

Provider Business Practice Location Address
First Line	:	1215 INDEPENDENCE BLVD
Second Line	:
City	:	ZACHARY
State	:	LA
Zip	:	70791-7390
Country	:	US
Telephone Number	:	225-286-1547
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2022
Last Update Date	:	09/02/2022

Similar Medicare Providers

1053645598 — LHCG XVI, LLC
Practice Location Address:

1215 INDEPENDENCE BLVD, BLDG 3, , SUITE B
ZACHARY, LA
70791-7390

Practice Phone: 225-683-3347
Practice Fax: 225-683-1278

1942676911 — MRS. KATHERINE L PERKINS APRN
Practice Location Address:

1215 INDEPENDENCE BLVD STE B
ZACHARY, LA
70791-7390

Practice Phone: 225-376-2128
Practice Fax: 866-493-3436

1003280512 — THE BONIN CLINIC LLC
Practice Location Address:

1215 INDEPENDENCE BLVD , 1A
ZACHARY, LA
70791-7390

Practice Phone: 225-570-2010
Practice Fax: 225-570-8573

1952855819 — TAYLOR ADDISON
Practice Location Address:

1215 INDEPENDENCE BLVD BLDG 6
ZACHARY, LA
70791-7390

Practice Phone: 225-286-1547
Practice Fax:

1912665373 — CATHERINE GRACE TALBOT
Practice Location Address:

1215 INDEPENDENCE BLVD BLDG 6
ZACHARY, LA
70791-7390

Practice Phone: 225-286-1547
Practice Fax:

1649939604 — KALI VIRGINIA MARIE NETTLES
Practice Location Address:

1215 INDEPENDENCE BLVD BLDG 6
ZACHARY, LA
70791-7390

Practice Phone: 225-286-1547
Practice Fax:

1154073294 — SHAMONE S WILLIAMS
Practice Location Address:

1215 INDEPENDENCE BLVD BLDG 6
ZACHARY, LA
70791-7390

Practice Phone: 225-286-1547
Practice Fax:

Directions to “ JACQUALYN LACOMBE BEHAVIOR TECH” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.