Individual
CRYSTALYN LAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
373 S WILLOW ST STE 266, MANCHESTER, NH 03103-5751
(877) 315-8080
Mailing address
373 S WILLOW ST STE 266, MANCHESTER, NH 03103-5751
(877) 315-8080
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-53103
NJ
103K00000X
Behavior Analyst
2021041483
MO
106S00000X
Behavior Technician
RBT-18-56144
LA
Other
Enumeration date
08/21/2018
Last updated
04/25/2023
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