Provider Demographics
NPI:1427618925
Name:OLIVER, MEAGAN (BCBA)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:OLIVER
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 1:15489 ATTERBERRY RD
Mailing Address - Street 2:
Mailing Address - City:WELSH
Mailing Address - State:LA
Mailing Address - Zip Code:70591-6507
Mailing Address - Country:US
Mailing Address - Phone:337-329-4152
Mailing Address - Fax:
Practice Address - Street 1:611 STATE ST
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-5315
Practice Address - Country:US
Practice Address - Phone:337-246-7546
Practice Address - Fax:866-616-5821
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst