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General NPI Number Information
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NPI Number | 1659004257
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Entity Type | Individual
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Provider Name | LOURDES LABOY
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Gender | Female
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Dates
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Enumeration Date | 07/01/2022
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Last Update Date | 07/06/2022
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Provider Practice Location Address
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Address Line | 424 CENTRAL AVE STE 2
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City | WESTFIELD
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State | NJ
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Zip | 07090-2561
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Country | US
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Telephone | 732-204-1635
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Fax |
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Provider Business Mailing Address
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Address Line | 61 3RD ST APT 1
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City | ELIZABETH
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State | NJ
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Zip | 07206-2748
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Country | US
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Telephone | 908-986-4920
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 000000000
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License Number State | NJ
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