Healthcare Provider Details

I. General information

NPI: 1669967717
Provider Name (Legal Business Name): MRS. LAUREN MUNSELL KALTENBACH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2018
Last Update Date: 07/20/2025
Certification Date: 07/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 MARINER BLVD
SPRING HILL FL
34609-5691
US

IV. Provider business mailing address

11034 GRASS FINCH RD
BROOKSVILLE FL
34613-3871
US

V. Phone/Fax

Practice location:
  • Phone: 800-217-9289
  • Fax: 888-751-4019
Mailing address:
  • Phone: 352-442-3449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-42049
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: