Provider Demographics
NPI:1720558406
Name:DIAZ-LUCIANO, LAURA ELIZABETH (M ED, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ELIZABETH
Last Name:DIAZ-LUCIANO
Suffix:
Gender:F
Credentials:M ED, BCBA
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:E
Other - Last Name:POGUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4349 LINGLESTOWN RD STE B
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-9196
Mailing Address - Country:US
Mailing Address - Phone:717-813-3090
Mailing Address - Fax:
Practice Address - Street 1:4349 LINGLESTOWN RD STE B
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-9196
Practice Address - Country:US
Practice Address - Phone:717-813-3090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst