Individual
JUSTIN DAKOTA TRIPPEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
925 OLIVE ST, SHREVEPORT, LA 71104-2103
(318) 300-3560
(318) 300-3561
Mailing address
925 OLIVE ST, SHREVEPORT, LA 71104-2103
(318) 300-3560
(318) 300-3561
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-693
LA
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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