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NPI Code Detail

MEDICARE: LAUREN DONOVAN

MEDICARE: LAUREN DONOVAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2103K00000XBehavior AnalystIL

General Provider Information

NPI Number : 1215542980
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN DONOVAN
Provider Business Mailing Address
First Line : 640 GRASSMERE PARK STE 116
Second Line :
City : NASHVILLE
State : TN
Zip : 37211-3678
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5705 WILLOW SPRINGS RD
Second Line :
City : COUNTRYSIDE
State : IL
Zip : 60525-3478
Country : US
Telephone Number : 312-965-2997
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2020
Last Update Date : 09/22/2023

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Directions to “ LAUREN DONOVAN ” Practice Location

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