Healthcare Provider Details

I. General information

NPI: 1326738519
Provider Name (Legal Business Name): LAUREN MARIE MUNDEN MA, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN MARIE MUNDEN MA, RBT

II. Dates (important events)

Enumeration Date: 05/10/2023
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

971 N GILBERT RD STE 101
GILBERT AZ
85234-3481
US

IV. Provider business mailing address

3500 DEPAUW BLVD STE 3070
INDIANAPOLIS IN
46268-6135
US

V. Phone/Fax

Practice location:
  • Phone: 480-559-8089
  • Fax: 317-520-8200
Mailing address:
  • Phone: 855-324-0885
  • Fax: 317-520-8200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90659
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: