| Masterminds Pediatric Therapy | |
|
801 Forest Drive Simpson LA 71474 | |
| (337) 375-7443 | |
| Not Available |
| Full Name | Masterminds Pediatric Therapy |
|---|---|
| Speciality | Behavior Analyst |
| Location | 801 Forest Drive, Simpson, Louisiana |
| Authorized Official Name and Position | Reagan Koury Merriman (OWNER) |
| Authorized Official Contact | 3373757443 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Masterminds Pediatric Therapy Po Box 328 Simpson LA 71474-0328 | Masterminds Pediatric Therapy 801 Forest Drive Simpson LA 71474 Ph: (337) 375-7443 |
| NPI Number | 1255022190 |
|---|---|
| Provider Enumeration Date | 05/19/2023 |
| Last Update Date | 05/19/2023 |
| Certification Date | 05/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255022190 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | () | Primary |