Healthcare Provider Details

I. General information

NPI: 1215702360
Provider Name (Legal Business Name): LAURA MARIA OLIVERA-MEJIA MS, BCBA-LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2023
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 S VAL VISTA DR STE 211
GILBERT AZ
85297-7322
US

IV. Provider business mailing address

3530 S VAL VISTA DR STE 211
GILBERT AZ
85297-7322
US

V. Phone/Fax

Practice location:
  • Phone: 623-263-3966
  • Fax:
Mailing address:
  • Phone: 646-270-6909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: