Provider Demographics
NPI:1205660834
Name:LAMOTTA, HALEY (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:LAMOTTA
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 LOVELAND RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-3117
Mailing Address - Country:US
Mailing Address - Phone:203-962-1644
Mailing Address - Fax:
Practice Address - Street 1:12 CAMBRIDGE DR
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4764
Practice Address - Country:US
Practice Address - Phone:203-429-5318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1957103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst