Most Relevant Information
Provider Data
| NPI Number: | 1003438854 |
| Provider Name: | LAUREN ELIZABETH HENDERSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/15/2020 |
| Last Updated: | 05/15/2020 |
Provider Practice Location
2810 PREMIERE PKWY
DULUTH
GA
300975014
Practice Location Phone/Fax
| Phone: | 2294859168 |
| Fax: |
Provider Mailing Location
PO BOX 399318
SAN FRANCISCO
CA
941399318
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |