Individual
LAWRENCE BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., BCBA
Contact information
Practice address
9040 ROSWELL RD STE 500, ATLANTA, GA 30350-1863
(248) 220-7980
Mailing address
27777 INKSTER RD STE 100, FARMINGTON HILLS, MI 48334-5312
(248) 220-7980
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-13-14572
CA
103K00000X
Behavior Analyst
Primary
1-13-14572
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-13-14572
BCBA
CA
Enumeration date
11/27/2013
Last updated
04/23/2025
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