Healthcare Provider Details

I. General information

NPI: 1356908297
Provider Name (Legal Business Name): ISABELLA LAUGHLIN BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2019
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 MARTIN LUTHER KING JR BLVD
EUGENE OR
97401-2475
US

IV. Provider business mailing address

154 BLACKFOOT AVE
EUGENE OR
97404-1607
US

V. Phone/Fax

Practice location:
  • Phone: 541-224-6987
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberABA-B-10267749
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: