Healthcare Provider Details

I. General information

NPI: 1063964153
Provider Name (Legal Business Name): BEATRIZ LUCINDA ROJAS M.S., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 04/27/2022
Certification Date: 04/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4615 W 103RD ST
OAK LAWN IL
60453-4718
US

IV. Provider business mailing address

5333 OAK CENTER DR
OAK LAWN IL
60453-3863
US

V. Phone/Fax

Practice location:
  • Phone: 331-229-8839
  • Fax:
Mailing address:
  • Phone: 773-719-9843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-18-33765
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: