Provider Demographics
NPI:1215443221
Name:LAFRANCE, TARA (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:LAFRANCE
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61-133 TUTU ST
Mailing Address - Street 2:
Mailing Address - City:HALEIWA
Mailing Address - State:HI
Mailing Address - Zip Code:96712-1355
Mailing Address - Country:US
Mailing Address - Phone:619-733-3935
Mailing Address - Fax:
Practice Address - Street 1:61-133 TUTU ST
Practice Address - Street 2:
Practice Address - City:HALEIWA
Practice Address - State:HI
Practice Address - Zip Code:96712-1355
Practice Address - Country:US
Practice Address - Phone:619-733-3935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABCBA-18-34146103K00000X
HI361103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst