| NPI | 1790729069 |
|---|---|
| Former Legal Business Name | AUTISM LEARNING CENTER |
| Entity Type | Organization |
| Authorized Contact | JANICE MOSS Insurance Administrator 318-323-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: LA 1059396) |
| 235Z00000X Speech-Language Pathologist, (Licence: LA 5508) | |
| 103K00000X Behavior Analyst (Licence: LA 1-08-4659) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2010-09-16 |