Healthcare Provider Details

I. General information

NPI: 1780235408
Provider Name (Legal Business Name): LAUREN T MILTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN BETH THORNE

II. Dates (important events)

Enumeration Date: 09/24/2019
Last Update Date: 03/10/2020
Certification Date: 03/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 SW RAILROAD AVE STE 130
HAMMOND LA
70403-5013
US

IV. Provider business mailing address

21600 OXNARD ST
WOODLAND HILLS CA
91367-4976
US

V. Phone/Fax

Practice location:
  • Phone: 985-500-3240
  • Fax:
Mailing address:
  • Phone: 818-345-2345
  • Fax: --

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLA-422
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: