Provider Demographics
NPI:1447780382
Name:CUBAS, LATASHA M (SSP, NCSP, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:LATASHA
Middle Name:M
Last Name:CUBAS
Suffix:
Gender:F
Credentials:SSP, NCSP, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 OAKMONT DR
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-1730
Mailing Address - Country:US
Mailing Address - Phone:770-940-1833
Mailing Address - Fax:
Practice Address - Street 1:128 OAKMONT DR
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-1730
Practice Address - Country:US
Practice Address - Phone:770-940-1833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TS0200X
LAL-186103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool