Provider Demographics
NPI:1992013569
Name:DR. RENEE' BABIN BONIN, L.L.C.
Entity Type:Organization
Organization Name:DR. RENEE' BABIN BONIN, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:BABIN
Authorized Official - Last Name:BONIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:337-504-3483
Mailing Address - Street 1:200 BEAULLIEU DR
Mailing Address - Street 2:BLDG 9B-1
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7230
Mailing Address - Country:US
Mailing Address - Phone:337-504-3483
Mailing Address - Fax:337-504-3573
Practice Address - Street 1:200 BEAULLIEU DR BLDG 9B-1
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7230
Practice Address - Country:US
Practice Address - Phone:337-504-3483
Practice Address - Fax:337-504-3573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-16
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3642101YM0800X
LA5048101YM0800X
LA4398101YM0800X
101YM0800X
LA1224103TC0700X
LAMP.0005103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty