Individual
MARY O'NEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
10450 ELLERBE RD, SHREVEPORT, LA 71106-7712
(318) 797-8500
(318) 797-0801
Mailing address
10450 ELLERBE RD, SHREVEPORT, LA 71106-7712
(318) 797-8500
(318) 797-0801
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LBA-193
LA
Other
Enumeration date
02/28/2017
Last updated
03/11/2022
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