Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 0-18-8605 | TN |
NPI | 1003313644 |
---|---|
Provider Name | Lauren Nicole Fairand |
First Address | Nashville, TN 37217-3921 |
Second Address | Clarksville, TN 37043-5987 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2018 |
Last Update Date | 10/04/2018 |