NPI 1710539473 · live from the CMS NPI Registry
Michael Laverdiere, BCBA
Behavior Analyst in Saint Cloud, MN. National Provider Identifier 1710539473, active.
NPI record
| NPI | 1710539473 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 3721 23rd St S Apt 201, Saint Cloud, MN 56301 |
| Practice phone | 218-457-2185 |
| Mailing address | 2804 E 26th St Ste 1, Sioux Falls, SD 57103 |
| Enumerated | July 12, 2019 |
| Last updated | June 3, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Assistant Behavior Analyst | 106E00000X | 09-19-10548 (MN) |
| Behavior Technician | 106S00000X | RBT-18-62994 (MI) |
| Behavior Analyst primary | 103K00000X | 1-20-42370 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.