Individual
LAUREN AMBER GIBEAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA, LABA
Contact information
Practice address
59 WILLIAM ST, WORCESTER, MA 01609-2161
(774) 402-0257
Mailing address
59 WILLIAM ST, WORCESTER, MA 01609-2161
(774) 402-0257
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
3930
MA
Other
Enumeration date
07/09/2018
Last updated
04/07/2022
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