Victoria Michel Boesen, MA, BCABA

Individual provider Active NPI Assistant Behavior Analyst · Prairieville, LA

NPI 1003597626 · NPPES record last updated Jul 27, 2023

Key facts

NPI
1003597626
Entity type
Individual (NPI type 1)
Primary specialty
Assistant Behavior Analyst 106E00000X
License
0-23-14540 (LA)
Practice address
17520 Old Jefferson Hwy
Prairieville, LA 70769-3903
Phone
(225) 300-6710
NPI assigned
Jul 27, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf South BR - ABA, LLC Past
since Jul 31, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 0-23-14540 LA Yes

Addresses

Primary practice location

17520 Old Jefferson Hwy
Prairieville, LA 70769-3903

Mailing address

14507 Essen Terrace Dr
Gonzales, LA 70737-7164
Phone (985) 233-1074

Other providers in Prairieville, LA

All providers in Prairieville, LA · Assistant Behavior Analyst in Louisiana

Sources for this page

Verify at the official NPI Registry.