Provider Demographics
NPI:1689952541
Name:NOACKLESAGE, DANIEL LEE (MA, BCBA, LBA)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:LEE
Last Name:NOACKLESAGE
Suffix:
Gender:M
Credentials:MA, BCBA, LBA
Other - Prefix:MR
Other - First Name:DANIEL
Other - Middle Name:LEE
Other - Last Name:LESAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, BCBA, LBA
Mailing Address - Street 1:741 HUDSONS WAY
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2671
Mailing Address - Country:US
Mailing Address - Phone:225-975-2924
Mailing Address - Fax:
Practice Address - Street 1:741 HUDSONS WAY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2671
Practice Address - Country:US
Practice Address - Phone:225-975-2924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-26
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-10-7617103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst