Provider Demographics
NPI:1902688583
Name:DUREL, ALEXIS (BCBA)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:DUREL
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 1:1420 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-4562
Mailing Address - Country:US
Mailing Address - Phone:504-300-7403
Mailing Address - Fax:
Practice Address - Street 1:1420 MAPLE ST
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-4562
Practice Address - Country:US
Practice Address - Phone:504-300-7403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst