Provider Demographics
NPI:1922544683
Name:DELAUNE, ELIZABETH L (BCBA, QASP, LABA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:L
Last Name:DELAUNE
Suffix:
Gender:F
Credentials:BCBA, QASP, LABA
Other - Prefix:
Other - First Name:LIBBY
Other - Middle Name:
Other - Last Name:DELAUNE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:179 CEDARWOOD LN
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-3102
Mailing Address - Country:US
Mailing Address - Phone:866-665-9779
Mailing Address - Fax:
Practice Address - Street 1:179 CEDARWOOD LN
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-3102
Practice Address - Country:US
Practice Address - Phone:866-665-9779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2318103K00000X
CT1-16-24816103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst