Provider Demographics
NPI:1386219624
Name:HOULE, LOREN (BCBA)
Entity Type:Individual
Prefix:MR
First Name:LOREN
Middle Name:
Last Name:HOULE
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4518 E CALGARY AVE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0763
Mailing Address - Country:US
Mailing Address - Phone:701-566-4007
Mailing Address - Fax:
Practice Address - Street 1:1929 N WASHINGTON ST STE GG
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-1669
Practice Address - Country:US
Practice Address - Phone:701-751-3732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDL77103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst