Healthcare Provider Details

I. General information

NPI: 1265913552
Provider Name (Legal Business Name): LAURA MORIN BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2018
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 PERRY ST
NEWNAN GA
30263-1918
US

IV. Provider business mailing address

15 PERRY ST
NEWNAN GA
30263-1918
US

V. Phone/Fax

Practice location:
  • Phone: 617-903-7669
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: