Individual
LACEY WASKIEWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., BCBA
Contact information
Practice address
90 CARANDO DR, SPRINGFIELD, MA 01104-4205
(413) 865-6919
Mailing address
257 PLEASANT ST, HOLYOKE, MA 01040-2653
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2022-385-MH-B1-APP
MA
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
01/03/2019
Last updated
12/09/2022
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