Individual
MIRANDA BERGEN TASSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., LBA, BCBA
Contact information
Practice address
7932 SUMMA AVE STE B2, BATON ROUGE, LA 70809-3736
(888) 880-9270
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-615
LA
Other
Enumeration date
10/08/2018
Last updated
03/10/2022
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