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Individual

CALEB JOHAN MILTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RBT

Contact information

Practice address
2715 MACKEY PL STE 230, SHREVEPORT, LA 71118-2544
(318) 779-1397
(318) 625-0586
Mailing address
8450 PARKDALE DR, SHREVEPORT, LA 71108-5322
(318) 655-8509

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
R-8252
LA
106S00000X
Behavior Technician
RBT-21-155534

Other

Enumeration date
03/01/2021
Last updated
03/01/2021
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