Provider Demographics
NPI:1215707864
Name:TRAVAGLINI, LAUREN (BCBA)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:TRAVAGLINI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BUCKALEW CT
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-1227
Mailing Address - Country:US
Mailing Address - Phone:609-658-6653
Mailing Address - Fax:
Practice Address - Street 1:663 RARITAN RD
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-3604
Practice Address - Country:US
Practice Address - Phone:848-448-9254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-23-69958103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst