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NPI Code Detail

MEDICARE: HEATHER LAWRENCE M.A., BCBA

MEDICARE: HEATHER LAWRENCE M.A., BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1295285401
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER LAWRENCE M.A., BCBA
Provider Business Mailing Address
First Line : 276 WINFALL BLVD
Second Line :
City : HERTFORD
State : NC
Zip : 27944-8829
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 18765 SW BOONES FERRY RD
Second Line :
City : TUALATIN
State : OR
Zip : 97062-8496
Country : US
Telephone Number : 503-612-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2016
Last Update Date : 05/25/2023

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