Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | RBT-21-155800 | GA |
NPI | 1003409509 |
---|---|
Provider Name | Lauren Mapp |
First Address | Indianapolis, IN 46268-6135 |
Second Address | Douglasville, GA 30135-1572 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2021 |
Last Update Date | 16/02/2021 |