Provider Demographics
NPI:1568725752
Name:ANDRUS, ADDIE FINDLEY (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:ADDIE
Middle Name:FINDLEY
Last Name:ANDRUS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7784 INNOVATION PARK DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70820-7006
Mailing Address - Country:US
Mailing Address - Phone:225-343-4232
Mailing Address - Fax:
Practice Address - Street 1:7784 INNOVATION PARK DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70820-7006
Practice Address - Country:US
Practice Address - Phone:225-343-4232
Practice Address - Fax:225-343-4233
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-12-10058103K00000X
LAL-034103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2357077Medicaid