Provider Demographics
NPI:1891090338
Name:RAWLINS, LAURA (MA BCBA)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:RAWLINS
Suffix:
Gender:F
Credentials:MA BCBA
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:RAWLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:180 GREAT HARBOR WAY
Mailing Address - Street 2:#3004
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-7204
Mailing Address - Country:US
Mailing Address - Phone:904-466-8460
Mailing Address - Fax:
Practice Address - Street 1:120 PALENCIA VILLAGE DR # C-105164
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32095-8549
Practice Address - Country:US
Practice Address - Phone:904-201-9129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-13
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-13-5734103K00000X
FL1-22-61081103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst