Provider Demographics
NPI:1346540218
Name:FOURNIER, LAUREN (MA BCBA)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:FOURNIER
Suffix:
Gender:F
Credentials:MA BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ALPINE ST
Mailing Address - Street 2:
Mailing Address - City:MILLBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01527-1902
Mailing Address - Country:US
Mailing Address - Phone:508-733-5103
Mailing Address - Fax:
Practice Address - Street 1:12 ALPINE ST
Practice Address - Street 2:
Practice Address - City:MILLBURY
Practice Address - State:MA
Practice Address - Zip Code:01527-1902
Practice Address - Country:US
Practice Address - Phone:508-733-5103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2012-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst