Provider Demographics
NPI:1700458858
Name:GREGOIRE, AMY (MA, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:GREGOIRE
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59660 THOMAS ROSS DR
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-5270
Mailing Address - Country:US
Mailing Address - Phone:225-323-3740
Mailing Address - Fax:
Practice Address - Street 1:1019 N RANGE AVE
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-2430
Practice Address - Country:US
Practice Address - Phone:225-791-0617
Practice Address - Fax:225-778-5439
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA661103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst