Provider Demographics
NPI:1124698097
Name:LAFOREST, OLIVIA MAE (MS, BCBA)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MAE
Last Name:LAFOREST
Suffix:
Gender:F
Credentials:MS, BCBA
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21600 OXNARD ST STE 1800
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-7807
Mailing Address - Country:US
Mailing Address - Phone:818-345-5234
Mailing Address - Fax:818-758-8015
Practice Address - Street 1:2121 S BLACKHAWK ST STE 100
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1488
Practice Address - Country:US
Practice Address - Phone:720-545-0768
Practice Address - Fax:720-368-5138
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COBACB456248103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst