Provider Demographics
NPI:1235722877
Name:LASCASE, BIANCA ABIGAIL
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:ABIGAIL
Last Name:LASCASE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 ECHO ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-6511
Mailing Address - Country:US
Mailing Address - Phone:774-360-0591
Mailing Address - Fax:
Practice Address - Street 1:69 ECHO ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-6511
Practice Address - Country:US
Practice Address - Phone:774-360-0591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health