Individual
TAYLA BRENEE LEBLANC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7932 SUMMA AVE STE B2, BATON ROUGE, LA 70809-3736
(225) 456-8321
Mailing address
3820 POPLAR GROVE DR, ADDIS, LA 70710-3012
(225) 439-6636
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W270000919
AETNA
—
Enumeration date
03/14/2022
Last updated
03/14/2022
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