Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-16-23630 | |
N | 103K00000X | Behavior Analyst | 183-140 | WI |
NPI | 1003336546 |
---|---|
Provider Name | Mrs. Lauren Renee Bean |
First Address | Nashville, TN 37217-2679 |
Second Address | Old Mill Creek, IL 60083 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2017 |
Last Update Date | 19/06/2019 |