Healthcare Provider Details

I. General information

NPI: 1134679889
Provider Name (Legal Business Name): LAUREN JANE CORCORAN BCBA, LABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN JANE CONLEY BCBA, LABA

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 LINCOLN ST STE 205
HINGHAM MA
02043-1741
US

IV. Provider business mailing address

185 LINCOLN ST STE 205
HINGHAM MA
02043-1741
US

V. Phone/Fax

Practice location:
  • Phone: 781-749-3606
  • 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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: