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Individual

DR. GARY WILLIAM LAVIGNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BCBA-D; PHD

Contact information

Practice address
5777 W CENTURY BLVD STE 675, LOS ANGELES, CA 90045-5632
(310) 871-0702
(818) 881-1935
Mailing address
5777 W CENTURY BLVD STE 675, LOS ANGELES, CA 90045-5632
(310) 871-0702
(818) 881-1935

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-02-09-40
CA
103T00000X
Psychologist
Primary
PSY5115
CA

Other

Enumeration date
07/22/2013
Last updated
07/22/2013
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