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Organization
BEHAVIOR TRAIN
Active
Organization
BEHAVIOR TRAIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI BEAVERS (CREDENTIALING MANAGER)
(318) 325-6200
Entity
Organization
Contact information
Practice address
628 COMMERCIAL PKWY STE 2, WEST MONROE, LA 71292-8062
(318) 588-8908
(318) 588-8909
Mailing address
PO BOX 1823, WEST MONROE, LA 71294-1823
(318) 588-8908
(318) 588-8909
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2415662
—
LA
Enumeration date
09/15/2015
Last updated
11/14/2025
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