Individual
LAUREN NOELLE REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA, LBA
Contact information
Practice address
1851 NW CIVIC DR, GRESHAM, OR 97030-5566
(971) 292-1050
Mailing address
13110 SW TRIGGER DR, BEAVERTON, OR 97008-7689
(661) 917-0827
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-20-42682
—
103K00000X
Behavior Analyst
Primary
ABA-B-10209084
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-20-42682
BACB
OR
01
—
ABA-B-10209084
BEHAVIOR ANALYSIS REGULATORY BOARD
OR
Enumeration date
01/30/2018
Last updated
10/02/2023
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