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Individual

MICHAEL LAVERDIERE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BCBA

Contact information

Practice address
3721 23RD ST S APT 201, SAINT CLOUD, MN 56301-6199
(218) 457-2185
(605) 271-3956
Mailing address
2804 E 26TH ST STE 1, SIOUX FALLS, SD 57103-4019
(605) 271-2690
(605) 271-3956

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-42370
MN
106E00000X
Assistant Behavior Analyst
09-19-10548
MN
106S00000X
Behavior Technician
RBT-18-62994
MI

Other

Enumeration date
07/12/2019
Last updated
06/03/2020
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