Provider Demographics
NPI:1821396789
Name:HOPPER, LAURA LEANNE (BCBA)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:LEANNE
Last Name:HOPPER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 ALLEN DR
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-1802
Mailing Address - Country:US
Mailing Address - Phone:573-275-1552
Mailing Address - Fax:
Practice Address - Street 1:2022 ALLEN DR
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-1802
Practice Address - Country:US
Practice Address - Phone:573-275-1552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011002241103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst