Healthcare Provider Details

I. General information

NPI: 1013411321
Provider Name (Legal Business Name): MARIE CHRISTINE LAFRONZA BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 11/27/2023
Certification Date: 12/26/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 EXECUTIVE PL STE 201
GENEVA IL
60134-3805
US

IV. Provider business mailing address

555 GUNDERSEN DR APT 506
CAROL STREAM IL
60188-3006
US

V. Phone/Fax

Practice location:
  • Phone: 630-400-6821
  • Fax:
Mailing address:
  • Phone: 630-400-6821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-19-39549
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number18-47920
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: