Healthcare Provider Details

I. General information

NPI: 1689438897
Provider Name (Legal Business Name): LAUREN CAULEY RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4511 NE COUNTY ROAD 219A
MELROSE FL
32666-6027
US

IV. Provider business mailing address

4511 NE COUNTY ROAD 219A
MELROSE FL
32666-6027
US

V. Phone/Fax

Practice location:
  • Phone: 352-727-9304
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: