Provider Demographics
NPI:1386106995
Name:REED, LINDA JOHNSON (BCBA)
Entity type:Individual
Prefix:MISS
First Name:LINDA
Middle Name:JOHNSON
Last Name:REED
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 NE EVANGELINE TRWY
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70507-2554
Mailing Address - Country:US
Mailing Address - Phone:337-534-8679
Mailing Address - Fax:337-534-0027
Practice Address - Street 1:3420 NE EVANGELINE TRWY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-2554
Practice Address - Country:US
Practice Address - Phone:337-534-8679
Practice Address - Fax:337-534-0027
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1-19-34638103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst