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NPI 1093697344

NPI 1093697344 : CASEY LASKARIS : FORTY FORT, PA

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General NPI Number Information
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    NPI Number           |    1093697344
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    Entity Type          |    Individual 
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    Provider Name        |    CASEY LASKARIS
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    Gender               |     
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Dates
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    Enumeration Date     |    07/25/2025
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    Last Update Date     |    07/25/2025
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Provider Practice Location Address
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    Address Line         |    190 WELLES ST STE 120 
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    City                 |    FORTY FORT
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    State                |    PA
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    Zip                  |    18704-4969
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    Country              |    US
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    Telephone            |    833-867-8371
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    Fax                  |    412-368-2701
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Provider Business Mailing Address
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    Address Line         |    203 HILL TOP DR 
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    City                 |    WEST WYOMING
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    State                |    PA
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    Zip                  |    18644-1207
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    103K00000X
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    Taxonomy Name        |    Behavior Analyst
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    License Number       |    
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    License Number State |    
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