Provider Demographics
NPI:1831661321
Name:LAUREN CALVOSA BCBA LLC
Entity Type:Organization
Organization Name:LAUREN CALVOSA BCBA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALVOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-692-0069
Mailing Address - Street 1:603 REVERE CT
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-2078
Mailing Address - Country:US
Mailing Address - Phone:908-692-0069
Mailing Address - Fax:
Practice Address - Street 1:603 REVERE CT
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-2078
Practice Address - Country:US
Practice Address - Phone:908-692-0069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty