Provider Demographics
NPI:1821552118
Name:DESROSIERS, LAURA (BCBA, LABA)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:DESROSIERS
Suffix:
Gender:
Credentials:BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 AUTUMN AVE
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-4621
Mailing Address - Country:US
Mailing Address - Phone:508-789-9323
Mailing Address - Fax:508-290-0783
Practice Address - Street 1:424 AUTUMN AVE
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-4621
Practice Address - Country:US
Practice Address - Phone:508-789-9323
Practice Address - Fax:508-290-0783
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2573103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst