Individual
LAURA M STACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., BCBA, LBA
Contact information
Practice address
1418 W OCEAN VIEW AVE, NORFOLK, VA 23503-1015
(757) 362-8388
(757) 210-3295
Mailing address
1418 W OCEAN VIEW AVE, NORFOLK, VA 23503-1015
(757) 362-8388
(757) 210-3295
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
0133000131
VA
103K00000X
Behavior Analyst
Primary
1-06-2849
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0133000131
MEDICAL LICENSE
VA
01
—
1-06-2849
BEHAVIOR ANALYST CERTIFICATION BOARD
—
Enumeration date
11/02/2006
Last updated
01/06/2020
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