Healthcare Provider Details

I. General information

NPI: 1275481681
Provider Name (Legal Business Name): ABBY STANISLAWSKI BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3716 MORMON COULEE RD
LA CROSSE WI
54601-7363
US

IV. Provider business mailing address

3500 BIRCH ST
LA CROSSE WI
54601-7868
US

V. Phone/Fax

Practice location:
  • Phone: 608-782-6480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1542-140
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: