Healthcare Provider Details

I. General information

NPI: 1437710225
Provider Name (Legal Business Name): BRIANNA LEIGH LASKEY BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRIANNA LEIGH GRIECO

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 WESTGATE DR
BROCKTON MA
02301-1818
US

IV. Provider business mailing address

375 WESTGATE DR
BROCKTON MA
02301-1818
US

V. Phone/Fax

Practice location:
  • Phone: 774-200-1260
  • Fax:
Mailing address:
  • Phone: 774-200-1260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-19-36906
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: