Provider Demographics
NPI:1851754766
Name:LAVEAU, BARNICA
Entity Type:Individual
Prefix:
First Name:BARNICA
Middle Name:
Last Name:LAVEAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11745 MARSDEN ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-2229
Mailing Address - Country:US
Mailing Address - Phone:347-233-0090
Mailing Address - Fax:
Practice Address - Street 1:11745 MARSDEN ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-2229
Practice Address - Country:US
Practice Address - Phone:347-233-0090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst