Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003580333 |
---|---|
Provider Name | Gabrielle Hebert |
First Address | Lafayette, LA 70508-8309 |
Second Address | Lake Charles, LA 70607-7066 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2021 |
Last Update Date | 06/12/2021 |