Provider Demographics
NPI:1558720219
Name:GALLAND, AMANDA (MA, BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:GALLAND
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 1:4019 PARLIAMENT DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3018
Mailing Address - Country:US
Mailing Address - Phone:318-308-9748
Mailing Address - Fax:888-432-2814
Practice Address - Street 1:4019 PARLIAMENT DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3018
Practice Address - Country:US
Practice Address - Phone:318-308-9748
Practice Address - Fax:888-432-2814
Is Sole Proprietor?:No
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL-140103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst