Provider Demographics
NPI:1609218494
Name:SANDERS, LAURA ANN (MA, BCBA, LABA)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ANN
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MA, BCBA, LABA
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ANN
Other - Last Name:CARBONARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 SUNSET RD
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-3543
Mailing Address - Country:US
Mailing Address - Phone:978-751-4046
Mailing Address - Fax:
Practice Address - Street 1:205 BURLINGTON RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1406
Practice Address - Country:US
Practice Address - Phone:781-862-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4094-MH-B1103K00000X
MA4094103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1004745OtherNHP
MA1303287OtherMBHP
MA042611055OtherTAX ID
MA1004745OtherFALLON
MAM18633OtherBCBS
MA0000023532OtherBMC
MA99618201OtherNETWORK HEALTH