Provider Demographics
NPI:1902354855
Name:NEAL, DANIENE (PHD, BCBA, LBA)
Entity Type:Individual
Prefix:DR
First Name:DANIENE
Middle Name:
Last Name:NEAL
Suffix:
Gender:F
Credentials:PHD, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9764 MARKET WEST DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-3637
Mailing Address - Country:US
Mailing Address - Phone:225-614-4665
Mailing Address - Fax:
Practice Address - Street 1:6555 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4237
Practice Address - Country:US
Practice Address - Phone:225-368-2297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL-275103K00000X
LA1268103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst