Individual
MAVE OPAL BERGERON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED, BCBA
Contact information
Practice address
139 JAMES COMEAUX RD STE B, LAFAYETTE, LA 70508-3376
(855) 832-6727
(772) 675-9100
Mailing address
328 S 2ND ST, IOTA, LA 70543-6051
(337) 305-6930
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L747
LA
Other
Enumeration date
07/21/2023
Last updated
04/01/2026
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