Provider Demographics
NPI:1487192761
Name:MECCARIELLO-BUCHAL, LAURIE (BCBA,MSED)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:
Last Name:MECCARIELLO-BUCHAL
Suffix:
Gender:F
Credentials:BCBA,MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 RYAN CT
Mailing Address - Street 2:
Mailing Address - City:CLINTON CORNERS
Mailing Address - State:NY
Mailing Address - Zip Code:12514-2041
Mailing Address - Country:US
Mailing Address - Phone:845-325-6165
Mailing Address - Fax:
Practice Address - Street 1:61 RYAN CT
Practice Address - Street 2:
Practice Address - City:CLINTON CORNERS
Practice Address - State:NY
Practice Address - Zip Code:12514-2041
Practice Address - Country:US
Practice Address - Phone:845-325-6165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-16-21515103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst