Provider Demographics
NPI:1770222598
Name:FREMIN, BOBBI KATHERINE (BCBA)
Entity Type:Individual
Prefix:
First Name:BOBBI
Middle Name:KATHERINE
Last Name:FREMIN
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:PO BOX 1137
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70302-1137
Mailing Address - Country:US
Mailing Address - Phone:985-447-7905
Mailing Address - Fax:859-447-7907
Practice Address - Street 1:1301 SAINT MARY ST
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-6527
Practice Address - Country:US
Practice Address - Phone:985-446-6833
Practice Address - Fax:985-446-6835
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL-641103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst