Individual
BIANCA L LAWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, M.ED
Contact information
Practice address
130 CORRIDOR RD UNIT 3292, PONTE VEDRA BEACH, FL 32004-7833
(904) 638-6388
Mailing address
2757 TREEMONT ST, JACKSONVILLE, FL 32207-4531
(904) 510-0935
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-57895
FL
106S00000X
Behavior Technician
RBT-17-33880
FL
Other
Enumeration date
04/17/2018
Last updated
02/15/2022
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