Individual
RAVEN LEIGH BAYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 N 3RD ST, LEESVILLE, LA 71446-4014
(337) 239-3334
Mailing address
112 N 3RD ST, LEESVILLE, LA 71446-4014
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-29250
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-18-29250
BACB
LA
Enumeration date
04/26/2018
Last updated
04/26/2018
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