Most Relevant Information
Provider Data
| NPI Number: | 1003529207 |
| Provider Name: | TIFFANY NICOLE NED LBA |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: | L-692 |
Most Important Dates
| Enumeration Date: | 01/03/2023 |
| Last Updated: | 01/03/2023 |
Provider Practice Location
714 N AVENUE K
CROWLEY
LA
705263849
Practice Location Phone/Fax
| Phone: | 3375145090 |
| Fax: |
Provider Mailing Location
714 N AVENUE K
CROWLEY
LA
705263849
Provider Mailing Phone/Fax
| Phone: | 3375145090 |
| Fax: |