Individual
MADISON DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
2912 WARREN AVE, LAKE CHARLES, LA 70601-8862
(337) 661-4041
Mailing address
250 CLEAR LAKE CIR, KILGORE, TX 75662-7242
(903) 522-9162
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-674
LA
Other
Enumeration date
10/10/2022
Last updated
10/10/2022
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