Provider Demographics
NPI:1740601848
Name:RICHTER, ERIKA (BCBA)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:RICHTER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 E TEXAS ST
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-3213
Mailing Address - Country:US
Mailing Address - Phone:318-635-9004
Mailing Address - Fax:318-584-7338
Practice Address - Street 1:3333 E TEXAS ST
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-3213
Practice Address - Country:US
Practice Address - Phone:318-635-9004
Practice Address - Fax:318-584-7338
Is Sole Proprietor?:No
Enumeration Date:2013-12-17
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X, 103K00000X
LAL-146103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2418301Medicaid