Organization
IMPACT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE R MARTINEZ BCBA (OWNER)
(504) 256-8714
Entity
Organization
Contact information
Practice address
6571 COLBERT ST, NEW ORLEANS, LA 70124-2204
(504) 256-8714
Mailing address
6571 COLBERT ST, NEW ORLEANS, LA 70124-2204
(504) 256-8714
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-255
LA
235Z00000X
Speech-Language Pathologist
LA-4947
LA
Other
Enumeration date
05/22/2018
Last updated
05/22/2018
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