Provider Demographics
NPI:1932333507
Name:THE BRAIN TRAIN DBA LEARNINGRX
Entity Type:Organization
Organization Name:THE BRAIN TRAIN DBA LEARNINGRX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONESA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:M ED
Authorized Official - Phone:318-671-0310
Mailing Address - Street 1:6331 W PORT AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-2415
Mailing Address - Country:US
Mailing Address - Phone:318-671-0310
Mailing Address - Fax:318-671-0320
Practice Address - Street 1:6331 W PORT AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-2415
Practice Address - Country:US
Practice Address - Phone:318-671-0310
Practice Address - Fax:318-671-0320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health