Provider Demographics
NPI:1194234245
Name:POMMIER, JOSHUA (BCBA)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:POMMIER
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 NATCHITOCHES DR
Mailing Address - Street 2:
Mailing Address - City:VILLE PLATTE
Mailing Address - State:LA
Mailing Address - Zip Code:70586-5705
Mailing Address - Country:US
Mailing Address - Phone:337-707-7749
Mailing Address - Fax:
Practice Address - Street 1:602 MCARTHUR ST
Practice Address - Street 2:
Practice Address - City:VILLE PLATTE
Practice Address - State:LA
Practice Address - Zip Code:70586-2908
Practice Address - Country:US
Practice Address - Phone:337-707-7749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-20
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1-17-27038103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAL-245OtherLICENSED BEHAVIOR ANALYST