Individual
AUSTIN SOUPHANTHALOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
758 ROYAL ST, BATON ROUGE, LA 70802-6433
(225) 529-3890
Mailing address
2803 MAYO ST, NEW IBERIA, LA 70560-8302
(337) 519-6698
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/29/2020
Last updated
01/29/2020
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