MEDICARE: MR. LAWRENCE DANIEL COTTINGHAM RBAI

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
1	106S00000X	Behavior Technician	ABA-IN-10258753	OR

General Provider Information

NPI Number	:	1538027610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LAWRENCE DANIEL COTTINGHAM RBAI

Provider Business Mailing Address
First Line	:	200 COMMERCIAL ST
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-5930
Country	:	US
Telephone Number	:	541-885-1675
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 COMMERCIAL ST
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-5930
Country	:	US
Telephone Number	:	541-885-1675
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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