Provider Demographics
NPI:1386885804
Name:O'ROURKE, LAURA B (MS, BCBA)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:B
Last Name:O'ROURKE
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17404 MERIDIAN E
Mailing Address - Street 2:SUITE F125
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375-6234
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17404 MERIDIAN E
Practice Address - Street 2:SUITE F125
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98375-6234
Practice Address - Country:US
Practice Address - Phone:630-901-9979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-12
Last Update Date:2015-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst